Healthcare Provider Details

I. General information

NPI: 1659696680
Provider Name (Legal Business Name): SONO X RAY RADIOLOGY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 AVE L MUNOZ MARIN QUADRANGLE MEDICAL CENTER, SUITE 208
CAGUAS PR
00725-3975
US

IV. Provider business mailing address

PO BOX 1778
CAGUAS PR
00726-1778
US

V. Phone/Fax

Practice location:
  • Phone: 787-746-1688
  • Fax: 787-703-0010
Mailing address:
  • Phone: 787-746-1688
  • Fax: 787-703-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCISCO LOUBRIEL-MENDEZ
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 787-746-1688