Provider Demographics
NPI:1073266029
Name:NEW MEDICAL QUALITY SERVICES CSP - RADIOLOGIA ANASCO
Entity Type:Organization
Organization Name:NEW MEDICAL QUALITY SERVICES CSP - RADIOLOGIA ANASCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CENTENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-435-8808
Mailing Address - Street 1:PO BOX 818
Mailing Address - Street 2:
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735-0818
Mailing Address - Country:US
Mailing Address - Phone:787-534-3789
Mailing Address - Fax:
Practice Address - Street 1:BO MARIAS CARRETERA 402 KM 1.8
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00735
Practice Address - Country:US
Practice Address - Phone:787-534-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW MEDICAL QUALITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-31
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology