Provider Demographics
NPI:1033289624
Name:AMERICAN RADIOLOGY AND CARDIOVASCULAR INST. OF THE SAN ANTONIO PSC
Entity Type:Organization
Organization Name:AMERICAN RADIOLOGY AND CARDIOVASCULAR INST. OF THE SAN ANTONIO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:HERNAN
Authorized Official - Last Name:LUGO OLIVIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-0050
Mailing Address - Street 1:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1019
Mailing Address - Country:US
Mailing Address - Phone:787-834-0050
Mailing Address - Fax:787-831-2104
Practice Address - Street 1:18 CALLE POST N
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-6626
Practice Address - Country:US
Practice Address - Phone:787-834-0050
Practice Address - Fax:787-831-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12412174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherRADIOLOGY