1659503795 NPI number — NEW VISION MEDICAL DIAGNOSTICS LLC

Table of content: (NPI 1659503795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659503795 NPI number — NEW VISION MEDICAL DIAGNOSTICS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW VISION MEDICAL DIAGNOSTICS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659503795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-5350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-778-5353
Provider Business Mailing Address Fax Number:
787-778-5302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE BARBOSA #36
Provider Second Line Business Practice Location Address:
ESQUINA MANUEL F ROSSY
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-778-5353
Provider Business Practice Location Address Fax Number:
787-778-5302
Provider Enumeration Date:
08/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
VARGAS RODRIGUEZ
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-778-5353

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QE0002X , with the licence number: 43 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com