| Organization Name: | GUAYAMA DIAGNOSTICS CSP |
| NPI Number: | 1265621551 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEANNINNE BADILLO RIVERA (OWNER/RADIOLOGIST) |
| Mailing Address: | Calle Ashford #1 Esq Vicente Pales Guayama |
| State: | PR US |
| Postal Code: | 007844950 |
| Phone Number: | 7878645670 |
| Fax Number: | 7878645714 |
| NPI Enumeration Date: | 10/23/2007 |
| NPI Last Update Date: | 02/20/2013 |
| 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: | |