Provider Demographics
NPI:1154452068
Name:DIAGNOSTIC IMAGING& RADIOLOGY SERVICES, PSC
Entity Type:Organization
Organization Name:DIAGNOSTIC IMAGING& RADIOLOGY SERVICES, PSC
Other - Org Name:ALBERTO M. COLON-ALVARADO, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:COLON-ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-829-1626
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-0037
Mailing Address - Country:US
Mailing Address - Phone:787-829-1626
Mailing Address - Fax:787-829-1665
Practice Address - Street 1:5516 RD KM 0.1
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:US
Practice Address - Phone:787-829-1626
Practice Address - Fax:787-829-1665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR02-224261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR02-224OtherCNC
PR02-224OtherCNC
PRH69150Medicare UPIN