Puerto Rico Endovascular & Vascular Solution, P.S.C

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PUERTO RICO ENDOVASCULAR & VASCULAR SOLUTION, P.S.C

Practice address

161 Calle San Jorge
Suite 402
San Juan, PR 00911-2176

Phone

(787) 723-4525

Fax

(787) 721-2574

NPI assigned

Oct 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jose Domingo Pagan

Title

Endovascular and Vascular Surgeon

Phone

(787) 723-4525

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1104179076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 CALLE SAN JORGE",
            "address_2": "SUITE 402",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009112176",
            "telephone_number": "787-723-4525",
            "fax_number": "787-721-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CALLE SAN JORGE",
            "address_2": "SUITE 402",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009112176",
            "telephone_number": "787-723-4525",
            "fax_number": "787-721-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUERTO RICO ENDOVASCULAR & VASCULAR SOLUTION, P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "PAGAN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DOMINGO",
        "authorized_official_title_or_position": "ENDOVASCULAR AND VASCULAR SURGEON",
        "authorized_official_telephone_number": "787-723-4525",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "12860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in San Juan, PR
• Providers in San Juan, PR by specialty
• Ambulatory Surgical Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.