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General NPI Number Information
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NPI Number | 1952443186
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL RADIOLOGY CENTER & MEDICAL GROUP, PSC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | INTERNATIONAL MARKETING CENTER SUITE C-107 1ST FL
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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 | 787-529-8163
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Fax |
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Provider Business Mailing Address
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Address Line | INTERNATIONAL MARKETING CENTER SUITE C-107 1ST FL
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | UM
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Telephone | 787-529-8163
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Fax |
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Authorized Official
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Title or Position | RADIOLOGY
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Name | DR. OSCAR CRESPO
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Credential | M.D.
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Telephone | 787-529-8163
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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 | 11391
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License Number State | PR
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