Healthcare Provider Details

I. General information

NPI: 1992862528
Provider Name (Legal Business Name): CENTRO TOMOGRAFICO DE PR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 ASHFORD AVENUE CONDADO
SAN JUAN PR
00907
US

IV. Provider business mailing address

PO BOX 364443
SAN JUAN PR
00936-4443
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-7878
  • Fax: 787-756-8934
Mailing address:
  • Phone: 787-721-7900
  • Fax: 787-756-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FRANK KOLODZIEJ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-759-7878