Healthcare Provider Details

I. General information

NPI: 1124003132
Provider Name (Legal Business Name): COMPREHENSIVE RADIOLOGICAL SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PASEO SAN PABLO EDIFICIO ARTURO CADILLA (SUITE 407)
BAYAMON PR
00961-7019
US

IV. Provider business mailing address

100 PASEO SAN PABLO EDIFICIO ARTURO CADILLA (SUITE 407)
BAYAMON PR
00961-7019
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-3955
  • Fax: 787-778-1144
Mailing address:
  • Phone: 787-740-3955
  • Fax: 787-778-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SAMUEL GARAU DIAZ
Title or Position: DIAGNOSTIC RADIOLOGY
Credential: MD
Phone: 787-740-3955