| Organization Name: | FAJARDO IMAGING MRI CSP |
| NPI Number: | 1295896587 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANA FERNADEZ GARCIA (RADIOLOGIST) |
| Mailing Address: | Ave Agustin Perez Andino B-30 Villas De Rio Grande Rio Grande |
| State: | PR US |
| Postal Code: | 00745 |
| Phone Number: | 7878875944 |
| Fax Number: | 7878877917 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 09/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0206X |
| License Number: | 5767 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mammography |
| Taxonomy Definition: | |