Healthcare Provider Details

I. General information

NPI: 1720474034
Provider Name (Legal Business Name): RADIATION ONCOLOGY AND PSYCHIATRY SERVICES C.S.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 04/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 AVE LAS CUMBRES OFIC 201
GUAYNABO PR
00969-5523
US

IV. Provider business mailing address

39 CALLE SAN EDMUNDO VILLA DE SAN IGNACIO
SAN JUAN PR
00927-6438
US

V. Phone/Fax

Practice location:
  • Phone: 787-731-5785
  • Fax:
Mailing address:
  • Phone: 787-731-5785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11379
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number11379
License Number StatePR

VIII. Authorized Official

Name: DR. JOSE M PALOU ABASOLO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-664-9538