Healthcare Provider Details

I. General information

NPI: 1427028018
Provider Name (Legal Business Name): CYRCORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CALLE BALDORIOTY
CIDRA PR
00739-3455
US

IV. Provider business mailing address

PO BOX 1904
CIDRA PR
00739-1904
US

V. Phone/Fax

Practice location:
  • Phone: 787-739-4472
  • Fax: 787-739-9318
Mailing address:
  • Phone: 787-739-4472
  • Fax: 787-739-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. RAFAEL RIVERA
Title or Position: VICE-PRESIDENT
Credential: RT
Phone: 787-739-4472