Provider Demographics
NPI:1073637211
Name:COAMO IMAGING CENTER
Entity Type:Organization
Organization Name:COAMO IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:FARINACCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-841-1949
Mailing Address - Street 1:PMB 128 PO BOX 2000
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715
Mailing Address - Country:US
Mailing Address - Phone:787-841-1949
Mailing Address - Fax:787-812-0565
Practice Address - Street 1:COAMO IMAGING
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-841-1949
Practice Address - Fax:787-812-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR135322085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020878Medicare ID - Type Unspecified