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General NPI Number Information
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NPI Number | 1265272892
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR RADIOLOGY INSTITUTE
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | TORRE SAN CRISTOBAL OFICINA #108 COTO LAUREL
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City | PONCE
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State | PR
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Zip | 00780
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Country | US
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Telephone | 787-268-1015
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Fax | 787-268-5511
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Provider Business Mailing Address
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Address Line | P.O. BOX 9101
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City | SAN JUAN
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State | PR
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Zip | 00908-9101
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Country | US
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Telephone | 787-268-1015
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Fax | 787-268-5511
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MR. GERARDO MARQUEZ SR.
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Credential |
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Telephone | 787-268-1015
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471N0900X
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Taxonomy Name | Nuclear Medicine Technology Radiologic Technologist
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License Number |
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License Number State |
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