Healthcare Provider Details

I. General information

NPI: 1306069901
Provider Name (Legal Business Name): SOCIEDAD DE RADIOLOGOS CONSULTORES,P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO RADIOLOGICO Y SONOGRAFICO DE MANATI CALLE MARGINAL ELLIOT VELEZ, ESQ. HERNANDEZ,URB. ATENAS
MANATI PR
00674
US

IV. Provider business mailing address

P. O. BOX 845
MANATI PR
00674-0845
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-3131
  • Fax: 787-854-3235
Mailing address:
  • Phone: 787-854-3131
  • Fax: 787-854-3235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier0085360
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerMEDICARE PTAN

VIII. Authorized Official

Name: DR. SAUL CORDERO-CALERO,
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-854-3131