Organization Name: | PENUELAS X RAY CSP |
NPI Number: | 1407181159 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAFAEL A MORA (PRESIDENT) |
Mailing Address: | Street Munoz Rivera # 907 Penuelas |
State: | PR US |
Postal Code: | 006240000 |
Phone Number: | 7874861512 |
Fax Number: | 7878411725 |
NPI Enumeration Date: | 10/14/2009 |
NPI Last Update Date: | 03/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |