Provider Demographics
NPI:1952474991
Name:VASCULAR PROFESSIONAL ULTRASOUND
Entity Type:Organization
Organization Name:VASCULAR PROFESSIONAL ULTRASOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-604-6796
Mailing Address - Street 1:PO BOX 367093
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7093
Mailing Address - Country:US
Mailing Address - Phone:787-767-7810
Mailing Address - Fax:
Practice Address - Street 1:500 AVE DOMENECH
Practice Address - Street 2:SUITE 401-A
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3736
Practice Address - Country:US
Practice Address - Phone:787-767-7810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057209Medicare ID - Type Unspecified