Basic Information
| Provider Information | |||||||||
| NPI: | 1811299043 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VIR ASSOCIATES PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 GRAND PASEO BOULEVARD | ||||||||
| Address2: | PMB 191, SUITE 112 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009265955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875075502 | ||||||||
| FaxNumber: | 7877717547 | ||||||||
| Practice Location | |||||||||
| Address1: | 735 AVE PONCE DE LEON | ||||||||
| Address2: | PARADA 37 | ||||||||
| City: | HATO REY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009175022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2010 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | HIDALGO | ||||||||
| AuthorizedOfficialFirstName: | ALEJANDRO | ||||||||
| AuthorizedOfficialMiddleName: | JORGE | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 7876716829 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | 16455 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
No ID Information.