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General NPI Number Information
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NPI Number | 1689747149
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Entity Type | Organization
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Legal Business Name | RADIOLOGOS ASOCIADOS DEL SUR
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8169 CALLE CONCORDIA EDIFICIO SAN VICENTE SUITE 1
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City | PONCE
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State | PR
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Zip | 00717-1554
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Country | US
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Telephone | 787-842-3073
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Fax | 787-844-8510
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Provider Business Mailing Address
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Address Line | P.O. BOX 3300383 ATOCHA STATION
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City | PONCE
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State | PR
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Zip | 00733-0383
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Country | US
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Telephone | 787-842-3073
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Fax | 787-844-8510
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE L TORRES
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Credential | M.D.
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Telephone | 787-842-3073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9822
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License Number State | PR
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