Provider Demographics
NPI:1033310420
Name:TOA ALTA X RAY SERVICES
Entity Type:Organization
Organization Name:TOA ALTA X RAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RODRIGUEZ
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:LUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-870-3245
Mailing Address - Street 1:PO BOX 364964
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4964
Mailing Address - Country:US
Mailing Address - Phone:787-870-3245
Mailing Address - Fax:
Practice Address - Street 1:CALLE ANTONIO R BARCELO NUM 27
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-870-3245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty