Provider Demographics
NPI:1932852894
Name:VEGA BAJA RADIOLOGY CENTER LLC
Entity Type:Organization
Organization Name:VEGA BAJA RADIOLOGY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEELLO CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-649-8221
Mailing Address - Street 1:3998 CARR 2
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-4140
Mailing Address - Country:US
Mailing Address - Phone:787-855-2687
Mailing Address - Fax:
Practice Address - Street 1:3998 CARR 2
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4140
Practice Address - Country:US
Practice Address - Phone:787-855-2687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty