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General NPI Number Information
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NPI Number | 1366884090
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Entity Type | Organization
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Legal Business Name | CENTO DE IMAGEN-RADIOLOGIA DIGITAL OMIAN INC.
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 61 CALLE GEORGETTI
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City | NARANJITO
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State | PR
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Zip | 00719-3027
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Country | US
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Telephone | 787-381-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 159 PASEO TORRE ALTA
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City | BARRANQUITAS
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State | PR
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Zip | 00794-9444
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Country | US
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Telephone | 787-381-4665
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | OMY R HERNANDEZ
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Credential |
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Telephone | 787-381-4665
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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 |
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License Number State |
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