Healthcare Provider Details

I. General information

NPI: 1821483587
Provider Name (Legal Business Name): HATO REY X-RAY AND IMAGING CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 ROOSEVELT AVENUE
SAN JUAN PR
00918
US

IV. Provider business mailing address

35 CALLE JUAN C BORBON STE 67 PMB 368
GUAYNABO PR
00969-5375
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-1422
  • Fax: 787-754-8555
Mailing address:
  • Phone: 787-754-1422
  • Fax: 787-754-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name: GRACE MARIN
Title or Position: PRESIDENT
Credential:
Phone: 787-754-1422