Healthcare Provider Details

I. General information

NPI: 1548572555
Provider Name (Legal Business Name): ECOIMAGENES DE PUERTO RICO, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. MILITAR KM. 112.9 SECTOR LA CURVA SUITE 101
ISABELA PR
00662-0000
US

IV. Provider business mailing address

PO BOX 1842
MOCA PR
00676-1842
US

V. Phone/Fax

Practice location:
  • Phone: 787-830-7900
  • Fax: 866-350-7282
Mailing address:
  • Phone: 787-830-7900
  • Fax: 866-350-7282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MISS ROSE MARIE LORENZO MALDONADO
Title or Position: PRESIDENT
Credential:
Phone: 787-830-7900