Healthcare Provider Details

I. General information

NPI: 1144752510
Provider Name (Legal Business Name): CAVERY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

METRO OFFICE PARK STE 203
GUAYNABO PR
00968-1704
US

IV. Provider business mailing address

METRO OFFICE PARK STE 203
GUAYNABO PR
00968-1704
US

V. Phone/Fax

Practice location:
  • Phone: 415-900-2000
  • Fax:
Mailing address:
  • Phone: 415-900-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number20855R0202X
License Number StateCA

VIII. Authorized Official

Name: AVERY J KNAPP JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 415-900-2000