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General NPI Number Information
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NPI Number | 1356514079
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Entity Type | Organization
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Legal Business Name | CENTRO RADIOLOGICO SONOGRAFICO COROZAL
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Dates
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Enumeration Date | 04/03/2008
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 14 CALLE LAS MERCEDES
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City | COROZAL
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State | PR
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Zip | 00783-1923
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Country | US
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Telephone | 787-802-1212
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Fax | 787-859-4410
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Provider Business Mailing Address
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Address Line | 14 CALLE LAS MERCEDES
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City | COROZAL
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State | PR
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Zip | 00783-1923
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Country | US
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Telephone | 787-802-1212
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Fax | 787-859-4410
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Authorized Official
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Title or Position | FACTURACION
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Name | MISS AMARILYS PEREZ
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Credential |
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Telephone | 787-802-1212
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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 | 4836
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License Number State | PR
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