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General NPI Number Information
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NPI Number | 1750863007
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Entity Type | Organization
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Legal Business Name | BM RADIOLOGY PSC
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | URB MONTEHIEDRA 87 BIENTEVEO
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-643-9929
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Fax |
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Provider Business Mailing Address
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Address Line | URB MONTEHIEDRA 87 BIENTEVEO
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-643-9929
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH BADILLO CECILIA
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Credential | MD
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Telephone | 787-643-9929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number | 17837
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License Number State | PR
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