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General NPI Number Information
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NPI Number | 1710211529
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Entity Type | Organization
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Legal Business Name | ADVANCED TECHNONUCLEAR IMAGING CENTER INC
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 525 AVE FD ROOSEVELT SUITE 401, LA TORRE DE PLAZA
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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 | 787-237-0554
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Fax | 787-282-0472
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Provider Business Mailing Address
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Address Line | 525 AVE FD ROOSEVELT SUITE 401, LA TORRE DE PLAZA
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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 | 787-237-0554
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Fax | 787-282-0472
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CARLOS D GARCIA
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Credential | M.D.
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Telephone | 787-548-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11861
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 11861
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License Number State | PR
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