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General NPI Number Information
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NPI Number | 1164482022
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Entity Type | Organization
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Legal Business Name | CENTRO DIANGOSTICO INTEGRAL PR INC
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 1801 AVE PONCE DE LEON
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City | SANTURCE
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State | PR
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Zip | 00909-1900
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Country | US
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Telephone | 787-726-0440
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Fax | 787-727-5574
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Provider Business Mailing Address
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Address Line | PO BOX 364367
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City | SAN JUAN
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State | PR
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Zip | 00936-4367
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Country | US
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Telephone | 787-726-0440
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Fax | 787-727-5574
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOSE MILTON SOLTERO
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Credential |
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Telephone | 787-726-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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