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General NPI Number Information
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NPI Number | 1205309325
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Entity Type | Organization
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Legal Business Name | SULTANA DIAGNOSTIC AND RADIOLOGIC
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | Q3-19 URB LAS LOMAS
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-461-0460
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1081
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City | TOA ALTA
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State | PR
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Zip | 00954-1081
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | SOENITH BONILLA GARCIA
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Credential |
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Telephone | 787-461-0460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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