Organization Name: | AIBONITO X RAY CORP |
NPI Number: | 1063697415 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IBARRA ORTEGA EDUARDO (ADMINISTRADOR) |
Mailing Address: | 204 Calle Julio Cintron Edificio Guayacan Suite 112 Aibonito |
State: | PR US |
Postal Code: | 007053311 |
Phone Number: | 7877358900 |
Fax Number: | 7877353055 |
NPI Enumeration Date: | 01/04/2008 |
NPI Last Update Date: | 01/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |