Provider Demographics
NPI:1275726408
Name:RADIO SURGERY GROUP
Entity Type:Organization
Organization Name:RADIO SURGERY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIATION-ONCOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-6070
Mailing Address - Street 1:PO BOX 8043
Mailing Address - Street 2:MARINA STATION
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-8043
Mailing Address - Country:US
Mailing Address - Phone:787-834-6070
Mailing Address - Fax:787-834-5535
Practice Address - Street 1:HOSP. DR. RAMON EMETERIO BETANCES
Practice Address - Street 2:ROAD #2 AVE. HOSTOS #410
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-6070
Practice Address - Fax:787-834-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR128292471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation TherapyGroup - Multi-Specialty