| Organization Name: | CENTRO RADIOLOGICO LUQUILLO PSC |
| NPI Number: | 1144233305 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SONIA V JIMENCI RESA (PROPIETARIA) |
| Mailing Address: | Carr. 193 Km 1 Local 5 Playa Azul Center Luquillo |
| State: | PR US |
| Postal Code: | 00773 |
| Phone Number: | 7878892483 |
| Fax Number: | 7878890432 |
| NPI Enumeration Date: | 08/15/2006 |
| NPI Last Update Date: | 04/20/2008 |
| 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: | |