| Dajaos Medical Center Csp | |
|
167 Road Km 11 0 Bo Dajaos Bayamon PR 00956-9711 | |
| (787) 730-3446 | |
| Not Available |
| Full Name | Dajaos Medical Center Csp |
|---|---|
| Speciality | Clinic/Center |
| Location | 167 Road Km 11 0 Bo Dajaos, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Rafael Vazquez Perez (PRESIDENT) |
| Authorized Official Contact | 7877303446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dajaos Medical Center Csp Rr 14 Box 5334 Bayamon PR 00956-9711 Ph: (787) 730-3446 | Dajaos Medical Center Csp 167 Road Km 11 0 Bo Dajaos Bayamon PR 00956-9711 Ph: (787) 730-3446 |
| NPI Number | 1528222676 |
|---|---|
| Provider Enumeration Date | 07/17/2008 |
| Last Update Date | 07/17/2008 |
| Medicare PECOS PAC ID | 6204969116 |
|---|---|
| Medicare Enrollment ID | O20100729000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528222676 | NPI | - | NPPES |
| 6320088 | Other | PR | HUMANA |
| 82154 | Other | PR | SSS |
| 500140 | Other | PR | MMM |
| 06548O | Other | PR | CRUZ AZUL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 894CP (Puerto Rico) | Primary |
| Provider Name | Rafael Vazquez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497723316 PECOS PAC ID: 9638202542 Enrollment ID: I20100729000688 |
| Provider Name | Ricardo Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1831285956 PECOS PAC ID: 7719201136 Enrollment ID: I20150113001236 |
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