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NPI Code Detail

MEDICARE: MAYAGUEZ ADVANCED RADIOTHERAPY CENTER

MEDICARE: MAYAGUEZ ADVANCED RADIOTHERAPY CENTER
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
12471R0002XRadiation Therapy Radiologic Technologist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3601345OTHERPRMEDICARE & MUCHO MAS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1592077OTHERPRSER SALUD BELLA VISTA
2510008OTHERPRPREFERRED HEALTH
43220-5OTHERPRPROSAM
555-92077OTHERPRPLAN DE SALUD UIA
67617OTHERPRINTERNATIONAL MEDICAL CAR
7900269OTHERPRAMERICAN HEALTH, INC.

General Provider Information

NPI Number : 1811932908
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAYAGUEZ ADVANCED RADIOTHERAPY CENTER
Provider Business Mailing Address
First Line : PO BOX 8043
Second Line :
City : MAYAGUEZ
State : PR
Zip : 00681-8043
Country : US
Telephone Number : 787-834-6070
Fax Number : 787-834-5535
Provider Business Practice Location Address
First Line : AVE HOSTOS
Second Line : CENTRO MEDICO RAMON E. BETANCES
City : MAYAGUEZ
State : PR
Zip : 00682-6353
Country : US
Telephone Number : 787-834-6070
Fax Number : 787-834-5535
Authorized Official
Title or Position : BILLING SUPERVISION
Name : MRS. ENID L CRESPO
Credential :
Telephone Number : 787-834-6070
Provider Enumeration Date : 06/20/2006
Last Update Date : 10/08/2008

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Directions to “MAYAGUEZ ADVANCED RADIOTHERAPY CENTER ” Practice Location

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