Healthcare Provider Details

I. General information

NPI: 1174766679
Provider Name (Legal Business Name): R.T. PROFESSIONAL SERVICES, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

Q3-19 CARR 21
SAN JUAN PR
00921-3308
US

IV. Provider business mailing address

PO BOX 908
BAYAMON PR
00960-0908
US

V. Phone/Fax

Practice location:
  • Phone: 787-438-5824
  • Fax:
Mailing address:
  • Phone: 787-438-5824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471R0002X
TaxonomyRadiation Therapy Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: OMAR O ORTEGA
Title or Position: MARKETING
Credential:
Phone: 787-438-5824