Provider Demographics
NPI:1528249265
Name:CLINICA DE CANCER Y ENFERMEDADES DE LA SANGRE, CSP
Entity type:Organization
Organization Name:CLINICA DE CANCER Y ENFERMEDADES DE LA SANGRE, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:VAZQUEZ-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-882-3975
Mailing Address - Street 1:PO BOX 5191
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605
Mailing Address - Country:US
Mailing Address - Phone:787-882-3975
Mailing Address - Fax:
Practice Address - Street 1:CARR 460 KM 0.2 BO CAIMITAL BAJO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-4055
Practice Address - Country:US
Practice Address - Phone:787-882-3975
Practice Address - Fax:787-997-0123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICA DE CANCER Y ENFERMEDADES DE LA SANGRE, CSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-23
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty