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NPI Code Detail

MEDICARE: LIGA PUERTORRIQUENA CONTRA EL CANCER

MEDICARE: LIGA PUERTORRIQUENA CONTRA EL CANCER
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
12085N0904XNuclear Radiology Physician
22085R0202XDiagnostic Radiology Physician
3261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center
42085B0100XBody Imaging Physician

General Provider Information

NPI Number : 1598075939
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIGA PUERTORRIQUENA CONTRA EL CANCER
Provider Business Mailing Address
First Line : PO BOX 191811
Second Line :
City : SAN JUAN
State : PR
Zip : 00919-1811
Country : US
Telephone Number : 787-753-8433
Fax Number :
Provider Business Practice Location Address
First Line : AVE AMERICO MIRANDA 150
Second Line : CENTRO MEDICO
City : RIO PIEDRAS
State : PR
Zip : 00935-0000
Country : US
Telephone Number : 787-753-8433
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MRS. ILIA GARCIA-DE RAMIREZ
Credential :
Telephone Number : 787-753-8433
Provider Enumeration Date : 10/19/2010
Last Update Date : 10/19/2010

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Directions to “LIGA PUERTORRIQUENA CONTRA EL CANCER ” Practice Location

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