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General NPI Number Information
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NPI Number | 1568452951
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Entity Type | Organization
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Legal Business Name | ASHFORD MEDICAL CENTER RADIOLOGY OFFICES PSC
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1451 AVE ASHFORD RADIOLOGY DEPARTMENT 1ST FLOOR OF ASHFORD PRESBYTERIAN
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City | SAN JUAN
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State | PR
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Zip | 00907-1511
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Country | US
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Telephone | 787-725-5955
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Fax | 787-722-7847
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Provider Business Mailing Address
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Address Line | 29 CALLE WASHINGTON STE 501
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City | SAN JUAN
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State | PR
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Zip | 00907-1510
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Country | US
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Telephone | 787-725-5955
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Fax | 787-722-7847
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. TERESITA LANDRON
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Credential | BA
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Telephone | 787-725-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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