Healthcare Provider Details
I. General information
NPI: 1265754766
Provider Name (Legal Business Name): SILRO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2010
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 AVE FD ROOSEVELT SUITE 401, LA TORRE DE PLAZA
SAN JUAN PR
00918-8001
US
IV. Provider business mailing address
CORREO ESMERALDA 53 PMB 114
GUAYNABO PUERTO RICO
00969
UM
V. Phone/Fax
- Phone: 787-754-0715
- Fax: 787-282-0472
- Phone:
- Fax: 787-282-0472
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | 4211 |
| License Number State | PR |
VIII. Authorized Official
Name: DR.
FRIEDA
SILVA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-754-0715