Healthcare Provider Details

I. General information

NPI: 1033183603
Provider Name (Legal Business Name): CARIBBEAN IMAGING AND RADIATION TREATMENT CENTER,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PONCE BY PASS SUIT 103 PARRA BUILDING 2225
PONCE PR
00717-1320
US

IV. Provider business mailing address

PONCE BY PASS SUIT 103 PARRA BUILDING 2225
PONCE PR
00717-1320
US

V. Phone/Fax

Practice location:
  • Phone: 787-842-2478
  • Fax: 787-841-2818
Mailing address:
  • Phone: 787-842-2478
  • Fax: 787-841-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANGEL RICARDO MARTINEZ
Title or Position: ADMINISTRATOR
Credential: B.A.
Phone: 787-842-2478