Provider Demographics
NPI:1720132046
Name:CAPARRA SONOGRAPHY AND VASCULAR STUDIO CENTER
Entity Type:Organization
Organization Name:CAPARRA SONOGRAPHY AND VASCULAR STUDIO CENTER
Other - Org Name:CAPARRA SONOGRAPHY AND VASCULAR STUDIO CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTA-FONTANET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-809-4025
Mailing Address - Street 1:390 CALLE GARDENIA
Mailing Address - Street 2:LA PONDEROSA
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-2201
Mailing Address - Country:US
Mailing Address - Phone:787-809-4025
Mailing Address - Fax:787-809-3424
Practice Address - Street 1:21 BDA LAS FLORES
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-5002
Practice Address - Country:US
Practice Address - Phone:787-809-4025
Practice Address - Fax:787-809-3424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty