Healthcare Provider Details

I. General information

NPI: 1962306662
Provider Name (Legal Business Name): INTERVENTIONAL RADIOLOGY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 CALLE CESAR GONZALEZ APT 1713
SAN JUAN PR
00918-3926
US

IV. Provider business mailing address

PO BOX 270401
SAN JUAN PR
00928-2401
US

V. Phone/Fax

Practice location:
  • Phone: 787-244-2903
  • Fax:
Mailing address:
  • Phone: 787-244-2903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LUIS F GARCIA PAREDES
Title or Position: PRESIDENT
Credential: MD
Phone: 787-244-2903