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General NPI Number Information
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NPI Number | 1508758525
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Entity Type | Organization
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Legal Business Name | CENTRO DE DIAGNOSTICO PARA INTELIGENCIAS MULTIPLES
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | CALLE VICTORIA 1551 SANTURCE
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City | SAN JUAN
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State | PR
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Zip | 00912
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Country | US
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Telephone | 787-722-9595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9023879
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City | SAN JUAN
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State | PR
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Zip | 00902-3879
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Country | US
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Telephone | 787-722-9595
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Fax |
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Authorized Official
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Title or Position | DIRECTORA
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Name | IDELIZ MATOS CRUZ
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Credential |
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Telephone | 787-722-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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