Healthcare Provider Details

I. General information

NPI: 1720075120
Provider Name (Legal Business Name): MONSERRATE IMAGING CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA MONSERRA BA 25
CAROLINA PR
00983
US

IV. Provider business mailing address

PARQUE DE ORIENTE #79 PASEO PARQUE
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-381-5091
  • Fax: 787-762-3850
Mailing address:
  • Phone: 787-755-3099
  • Fax: 787-748-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0252
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS BALSALOBRE
Title or Position: DIRECTOR
Credential:
Phone: 787-381-5091