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General NPI Number Information
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NPI Number | 1568415867
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Entity Type | Organization
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Legal Business Name | P.E.T. NUCLEAR RADIOLOGY, INC.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | EDIFICIO BETANCOURT SUITE 302 FERNNDEZ JUNCOS AVE. # 1501
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City | SANTURCE
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-727-2738
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Fax | 787-728-4799
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Provider Business Mailing Address
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Address Line | P.M.B. 322 P.O. BOX 7891
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City | GUAYNABO
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State | PR
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Zip | 00970
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Country | US
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Telephone | 787-727-2738
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Fax | 787-728-4799
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUAN ENRIQUE PEREZ-MONTE
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Credential | M.D.
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Telephone | 787-727-2738
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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 | 05-126
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License Number State | PR
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