Provider Demographics
NPI:1235442823
Name:CDT CENTRO DE SERVICIOS MEDICOS INTEGRADOS, INC.
Entity Type:Organization
Organization Name:CDT CENTRO DE SERVICIOS MEDICOS INTEGRADOS, INC.
Other - Org Name:CENTRO RADIOLOGICO CESMI
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-778-2145
Mailing Address - Street 1:59 CALLE SANTA CRUZ
Mailing Address - Street 2:4TO PISO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6900
Mailing Address - Country:US
Mailing Address - Phone:787-778-2145
Mailing Address - Fax:787-778-2110
Practice Address - Street 1:59 CALLE SANTA CRUZ
Practice Address - Street 2:4TO PISO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6900
Practice Address - Country:US
Practice Address - Phone:787-778-2145
Practice Address - Fax:787-778-2110
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CDT CENTRO DE SERVICIOS MEDICOS INTEGRADOS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR92261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology