Provider Demographics
NPI:1063243996
Name:VASCULAR INSTITUTE OF PUERTO RICO LLC
Entity type:Organization
Organization Name:VASCULAR INSTITUTE OF PUERTO RICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREIRA TORRELLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-222-3697
Mailing Address - Street 1:35 CALLE JUAN C BORBON STE 67-148
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5375
Mailing Address - Country:US
Mailing Address - Phone:787-222-3697
Mailing Address - Fax:787-535-1006
Practice Address - Street 1:CENTRO MEDICO MENONITA CAYEY
Practice Address - Street 2:OFICINA 205
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-2800
Practice Address - Country:US
Practice Address - Phone:787-222-3697
Practice Address - Fax:787-535-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty