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General NPI Number Information
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NPI Number | 1215925870
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Entity Type | Organization
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Legal Business Name | CENTRO RADIOLOGICO DE ISABELA
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4 CALLE MUNOZ RIVERA
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City | ISABELA
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State | PR
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Zip | 00662-3006
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Country | US
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Telephone | 787-872-4888
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Fax | 787-872-8181
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Provider Business Mailing Address
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Address Line | PO BOX 946
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City | ISABELA
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State | PR
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Zip | 00662-0946
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Country | US
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Telephone | 787-872-4888
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Fax | 787-872-8181
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Authorized Official
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Title or Position | OWNER/MEDICAL SUPERVISOR
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Name | DR. GILBERTO RODRIGUEZ-SANTIAGO
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Credential | M.D.
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Telephone | 787-872-4888
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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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