Provider Demographics
NPI:1215232590
Name:SERVICIOS MEDICOS UNIVERSITARIOS INC
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS UNIVERSITARIOS INC
Other - Org Name:CENTRO DE IMAGENES HOSPITAL UPR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-757-1800
Mailing Address - Street 1:PO BOX 6021
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984
Mailing Address - Country:US
Mailing Address - Phone:787-757-1800
Mailing Address - Fax:787-750-4481
Practice Address - Street 1:CARRETERA 3 KM 8.3
Practice Address - Street 2:AVE. 65TH INFANTERIA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:787-750-4481
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO DE IMAGENES HOSPITAL UPR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-19
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies