Healthcare Provider Details

I. General information

NPI: 1336136423
Provider Name (Legal Business Name): LABORATORIO MEDECINA NUCLEAR & PET INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO CARDIO VASCULAR DE PR Y EL CARIBE 1ER PISO ESQUINA A MEDICO MIRANDA ENTRADA PRINCIPAL
RIO PIEDRA PR
00924
US

IV. Provider business mailing address

PO BOX 360064
SAN JUAN PR
00936-0064
US

V. Phone/Fax

Practice location:
  • Phone: 787-751-4222
  • Fax: 787-751-4180
Mailing address:
  • Phone: 787-751-4222
  • Fax: 787-751-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291900000X
TaxonomyMilitary Clinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGEL A CINTRON
Title or Position: PRESIDENT
Credential: MD
Phone: 787-751-4222