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General NPI Number Information
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NPI Number | 1588857833
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Entity Type | Organization
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Legal Business Name | PLAZA NUCLEAR IMAGING
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 525 AVE FD ROOSEVELT LA TORRE DE PLAZA SUITE 401
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City | SAN JUAN
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State | PR
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Zip | 00918-8001
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Country | US
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Telephone | 787-754-0715
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Fax | 787-282-0472
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Provider Business Mailing Address
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Address Line | ESMERALDA AVE 53 CORREO ESMERALDA PMB 114
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone |
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Fax | 787-282-0472
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRIEDA SILVA
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Credential | MD
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Telephone | 787-754-0715
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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 | PR-2001-23
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License Number State | PR
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