Provider Demographics
NPI:1124598107
Name:BUEN SAMARITANO RADIOLOGY MEDICAL BILLING SERVICES
Entity Type:Organization
Organization Name:BUEN SAMARITANO RADIOLOGY MEDICAL BILLING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL SERVICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-658-0000
Mailing Address - Street 1:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4055
Mailing Address - Country:US
Mailing Address - Phone:787-658-0000
Mailing Address - Fax:787-658-0640
Practice Address - Street 1:18 AVE SEVERIANO CUEVAS BO CAIMITAL BAJO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL COMUNITARIO BUEN SAMARITANO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty