Healthcare Provider Details

I. General information

NPI: 1265803597
Provider Name (Legal Business Name): MULTI MEDICAL FACILITIES X-RAY & SONOGRAPHY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 AVENIDA MUNOZ RIVERA
SAN JUAN PR
00919
US

IV. Provider business mailing address

PO BOX 19400 PMB 196
SAN JUAN PR
00918-4000
US

V. Phone/Fax

Practice location:
  • Phone: 787-705-8677
  • Fax: 787-763-5977
Mailing address:
  • Phone: 787-705-8677
  • Fax: 787-763-5977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LUZ CELENIA CASTELLANOS
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-705-8677