Healthcare Provider Details

I. General information

NPI: 1013014422
Provider Name (Legal Business Name): CARIBBEAN RADIATION ONCOLOGY CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11-25 CARR. 174 URB. SANTA ROSA
BAYAMON PR
00959-6609
US

IV. Provider business mailing address

P.O. BOX 958
BAYAMON PR
00960-0958
US

V. Phone/Fax

Practice location:
  • Phone: 787-993-2800
  • Fax: 787-778-5472
Mailing address:
  • Phone: 787-993-2800
  • Fax: 787-778-5472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology 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: MR. PEDRO A. SERRANO-OJEDA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-993-2800