Healthcare Provider Details

I. General information

NPI: 1518189018
Provider Name (Legal Business Name): CENTRO RADIOLOGICO MOROVIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMERCIO 11
MOROVIS PR
00687
US

IV. Provider business mailing address

P O BOX 2120
MOROVIS PR
00687
US

V. Phone/Fax

Practice location:
  • Phone: 787-862-3502
  • Fax: 787-862-7247
Mailing address:
  • Phone: 787-862-3502
  • Fax: 787-862-7247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIA E. MARTINEZ
Title or Position: DIRECTOR
Credential: M.D.
Phone: 787-862-3502