Provider Demographics
NPI:1124003132
Name:COMPREHENSIVE RADIOLOGICAL SYSTEM
Entity Type:Organization
Organization Name:COMPREHENSIVE RADIOLOGICAL SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIAGNOSTIC RADIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARAU DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-740-3955
Mailing Address - Street 1:100 PASEO SAN PABLO
Mailing Address - Street 2:EDIFICIO ARTURO CADILLA (SUITE 407)
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7019
Mailing Address - Country:US
Mailing Address - Phone:787-740-3955
Mailing Address - Fax:787-778-1144
Practice Address - Street 1:100 PASEO SAN PABLO
Practice Address - Street 2:EDIFICIO ARTURO CADILLA (SUITE 407)
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7019
Practice Address - Country:US
Practice Address - Phone:787-740-3955
Practice Address - Fax:787-778-1144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29122Medicare PIN