Provider Demographics
NPI:1053307736
Name:CENTRO SONONUCLEAR DE RIO PIEDRAS
Entity Type:Organization
Organization Name:CENTRO SONONUCLEAR DE RIO PIEDRAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-764-2355
Mailing Address - Street 1:24 CALLE ACEROLA
Mailing Address - Street 2:URB. MILAVILLE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5105
Mailing Address - Country:US
Mailing Address - Phone:787-764-2355
Mailing Address - Fax:787-763-1714
Practice Address - Street 1:1028 CALLE LOS ANGELES
Practice Address - Street 2:URB DEL CARMEN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-2646
Practice Address - Country:US
Practice Address - Phone:787-764-2355
Practice Address - Fax:787-763-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & TherapyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR64989OtherTRIPLE S
PR83910Medicare ID - Type UnspecifiedSONONUCRIO PIEDRA
PR83370Medicare ID - Type UnspecifiedSONONUCLEAR RYDER