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NPI Code Detail

MEDICARE: GUAYNABO HEALTH PROVIDERS, CORP.

MEDICARE: GUAYNABO HEALTH PROVIDERS, CORP.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician
22085U0001XDiagnostic Ultrasound Physician
3261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center
4261QR0206XMammography Clinic/Center
5261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1063780534
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUAYNABO HEALTH PROVIDERS, CORP.
Provider Business Mailing Address
First Line : PMB 205 PO BOX 70344
Second Line :
City : SAN JUAN
State : PR
Zip : 00936-8344
Country : US
Telephone Number : 787-720-5050
Fax Number : 787-720-4949
Provider Business Practice Location Address
First Line : 140 AVE LAS CUMBRES
Second Line : GUAYNABO MEDICAL MALL
City : GUAYNABO
State : PR
Zip : 00969-5523
Country : US
Telephone Number : 787-720-5050
Fax Number : 787-720-4949
Authorized Official
Title or Position : PRESIDENT
Name : LILIANA MEDINA OTERO
Credential :
Telephone Number : 787-720-5050
Provider Enumeration Date : 12/12/2011
Last Update Date : 12/12/2011

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Practice Location Address:
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00968
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1891771697 — DR. LEONARDO ORTIZ
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Practice Fax:
1043270960 — DARICE OROBITG PH.D.
Practice Location Address:
140 AVE LAS CUMBRES , GUAYNABO MEDICAL MALL SUITE 201
GUAYNABO, PR
00969-5523
Practice Phone: 787-412-8365
Practice Fax:
1407897994 — JOSE M PALOU ABASOLO M.D.
Practice Location Address:
140 AVE LAS CUMBRES , 140 AVE LAS CUMBRES OFIC 201
GUAYNABO, PR
00969-5523
Practice Phone: 787-731-5785
Practice Fax: 787-287-2487
1598828352 — LILIANA ZOE MIRANDA M.D.
Practice Location Address:
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GUAYNABO, PR
00969-5523
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Practice Fax: 787-287-2487
1265625578 — MRS. MARIA M ACEVEDO TORAL RD
Practice Location Address:
140 AVE LAS CUMBRES , GUAYNABO MEDICAL MALL LOCAL B
GUAYNABO, PR
00969-5523
Practice Phone: 787-710-2532
Practice Fax:
1043499445 — DR. JOHANNY HERNANDEZ
Practice Location Address:
140 AVE LAS CUMBRES
GUAYNABO, PR
00969-5523
Practice Phone: 787-720-5050
Practice Fax:

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