| Doctor Name: | DR. JORGE ALBERTO VIDAL |
| NPI Number: | 1487664454 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | D64849 |
| Business Practice Address: | 267 Sierra Morena Pmb 283 Urb Las Cumbres San Juan, PR - 009265636 |
| Business Phone Number: | 7872563222 |
| Business Fax Number: | |
| Mailing Address: | 267 Sierra Morena Urb Las Cumbres, Pmb 283 SAN JUAN |
| State: | PR |
| Postal Code: | 009265636 |
| Phone Number: | 7872563222 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 11/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | D64849 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |