| Organization Name: | CENTRO RADIOLOGICO DE LA MONTANA PSC |
| NPI Number: | 1164851804 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GILBERTO VAZQUEZ (PRESIDENT) |
| Mailing Address: | Hc 72 Box 3951 Naranjito |
| State: | PR US |
| Postal Code: | 007198771 |
| Phone Number: | 7878692687 |
| Fax Number: | 7878690536 |
| NPI Enumeration Date: | 11/04/2013 |
| NPI Last Update Date: | 11/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0206X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mammography |
| Taxonomy Definition: | |