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General NPI Number Information
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NPI Number | 1447524236
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Entity Type | Organization
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Legal Business Name | RIO GRANDE NUCLEAR PSC
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 13 CALLE SAN JUAN ESQ. DEL CARMEN
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City | RIO GRANDE
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State | PR
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Zip | 00745-3015
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Country | US
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Telephone | 787-887-7021
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Fax | 787-887-3115
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Provider Business Mailing Address
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Address Line | PO BOX 1569
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City | RIO GRANDE
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State | PR
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Zip | 00745-1569
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Country | US
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Telephone | 787-887-7055
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Fax | 787-887-3115
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENIS F RUIZ-SERRANO
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Credential | M.D.
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Telephone | 787-887-7055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology 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 | 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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