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General NPI Number Information
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NPI Number | 1699573899
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Entity Type | Organization
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Legal Business Name | ELITE CARE RADIOLOGY
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | BO. CAIMITAL CARR PR 2 KM 122.0
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City | AGUADILLA
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State | PR
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Zip | 00605
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Country | US
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Telephone | 787-641-0171
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 AVE PONCE DE LEON STE 204
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City | SAN JUAN
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State | PR
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Zip | 00907-3949
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Country | US
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Telephone | 787-641-0171
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HIRAM J ORTEGA
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Credential |
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Telephone | 787-431-6710
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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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