Provider Demographics
NPI:1134666241
Name:NL RADIOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NL RADIOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-365-2432
Mailing Address - Street 1:PO BOX 270236
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-3036
Mailing Address - Country:US
Mailing Address - Phone:787-308-0449
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO ARTURO CADILLA 403
Practice Address - Street 2:PASEO SAN PABLO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-308-0449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR177522085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty