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General NPI Number Information
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NPI Number | 1477826733
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Entity Type | Organization
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Legal Business Name | NOBLE DIAGNOSTIC IMAGING PSC
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Dates
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Enumeration Date | 02/17/2012
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | CARR. 189 BO. RINCON, MARINA PLAZA
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-737-5280
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Fax |
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Provider Business Mailing Address
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Address Line | BOX 106
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City | JUNCOS
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State | PR
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Zip | 00777-0000
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Country | US
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Telephone | 787-459-3344
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Fax |
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Authorized Official
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Title or Position | ADMINISTRADORA
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Name | MRS. LORENA NOBLE
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Credential |
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Telephone | 787-459-3344
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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 | PR
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