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General NPI Number Information
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NPI Number | 1366767337
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Entity Type | Organization
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Legal Business Name | AGUADILLA X-RAY OFFICE & BODY IMAGING CENTER, PSC
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Dates
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Enumeration Date | 04/02/2010
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Last Update Date | 04/02/2010
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Provider Practice Location Address
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Address Line | AGUADILLA MED. BLDG., OFIC. 302 PROGRESO #2 & #3
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City | AGUADILLA
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State | PR
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Zip | 00605-0418
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Country | US
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Telephone | 787-891-6165
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Fax | 787-891-6566
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Provider Business Mailing Address
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Address Line | PO BOX 418
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City | AGUADILLA
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State | PR
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Zip | 00605-0418
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Country | US
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Telephone | 787-891-6165
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Fax | 787-891-6566
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. JOSE E RIVERA RODRIGUEZ
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Credential | M.D.
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Telephone | 787-891-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 008589
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License Number State | PR
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