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General NPI Number Information
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NPI Number | 1215142609
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Entity Type | Organization
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Legal Business Name | OPEN MRI OF PR
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 1501 FDZ JUNCOS AVE SUITE 101 EDIF BETANCOURT
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City | SAN JUAN
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State | PR
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Zip | 00910
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Country | US
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Telephone | 787-268-6736
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8135
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City | SAN JUAN
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State | PR
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Zip | 00910-0135
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Country | US
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Telephone | 787-268-6736
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Fax |
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Authorized Official
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Title or Position | RADIOLOGY
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Name | DR. OSCAR CRESPO QUINONES
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Credential | M.D.
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Telephone | 787-268-6736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 11391
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License Number State | PR
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