Healthcare Provider Details

I. General information

NPI: 1871497933
Provider Name (Legal Business Name): ULTRASCAN MOBILE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11044 MONTE BELLO
VILLALBA PR
00766-2357
US

IV. Provider business mailing address

11044 MONTE BELLO
VILLALBA PR
00766-2357
US

V. Phone/Fax

Practice location:
  • Phone: 939-496-8015
  • Fax:
Mailing address:
  • Phone: 939-496-8015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIA DEL CARMEN GONZALEZ HERNANDEZ
Title or Position: OWNER
Credential: RDMS
Phone: 939-496-8015