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General NPI Number Information
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NPI Number | 1073731659
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Entity Type | Organization
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Legal Business Name | GEORGETTI MEDICAL IMAGING CENTER
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Dates
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Enumeration Date | 04/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 62 CALLE GEORGETTI
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City | SAN JUAN
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State | PR
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Zip | 00925-3607
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Country | US
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Telephone | 787-754-1980
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 366684
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City | SAN JUAN
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State | PR
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Zip | 00936-6684
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Country | US
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Telephone | 787-754-1980
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Fax | 787-754-8202
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. NITZA MAGALI DEMARI-PRATS
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Credential | MD
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Telephone | 787-754-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4222
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License Number State | PR
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