Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 21323 | PR |
NPI | 1811384753 |
---|---|
Provider Name | Oscar Rafael Vazquez Ortiz |
First Address | San Juan, PR 00907 |
Second Address | Guayama, PR 00784-6648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 20/06/2019 |