Healthcare Provider Details

I. General information

NPI: 1982840153
Provider Name (Legal Business Name): CENTRO DE DIAGNOSTICO Y TRATAMIENTO DE YABUCOA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR.901 CALLE SATURNINO RODRIGUEZ
YABUCOA PR
00726
US

IV. Provider business mailing address

PO BOX 8548
YABUCOA PR
00726
US

V. Phone/Fax

Practice location:
  • Phone: 787-893-0480
  • Fax: 787-771-2295
Mailing address:
  • Phone: 787-893-0480
  • Fax: 787-771-2295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARMEN R RODRIGUEZ
Title or Position: DIRECTORA EJECUTIVA
Credential: MPA
Phone: 787-771-2100