Provider Demographics
NPI:1003171174
Name:CENTRO RADIOLOGICO INDUSTRIAL DE CAGUAS PSC
Entity Type:Organization
Organization Name:CENTRO RADIOLOGICO INDUSTRIAL DE CAGUAS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-257-6800
Mailing Address - Street 1:PO BOX 20160
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-0160
Mailing Address - Country:US
Mailing Address - Phone:787-625-1192
Mailing Address - Fax:787-625-1195
Practice Address - Street 1:CORP FSE
Practice Address - Street 2:AVE LUIS MUNOZ MARIN EDIF MERCANTIL
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-625-1192
Practice Address - Fax:787-625-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2632261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology