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General NPI Number Information
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NPI Number | 1336617513
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Entity Type | Organization
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Legal Business Name | NUSCAN HUMACAO
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 18 AVE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3342
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Country | US
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Telephone | 787-741-6278
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Fax | 787-744-5433
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Provider Business Mailing Address
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Address Line | PO BOX 6960
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City | CAGUAS
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State | PR
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Zip | 00726-6960
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Country | US
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Telephone | 787-744-5278
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Fax | 787-744-5433
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. HIRAM RIVERA LUNA
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Credential | MD
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Telephone | 787-744-5278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State |
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