Provider Demographics
NPI:1326012675
Name:SAN PATRICIO MRI & CT CENTER, P.S.C.
Entity Type:Organization
Organization Name:SAN PATRICIO MRI & CT CENTER, P.S.C.
Other - Org Name:SAN PATRICIO MEDFLIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALDUONDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-620-5757
Mailing Address - Street 1:280 AVE MARGINAL KENNEDY
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-1746
Mailing Address - Country:US
Mailing Address - Phone:787-620-5757
Mailing Address - Fax:787-905-7921
Practice Address - Street 1:280 AVE MARGINAL KENNEDY
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-1746
Practice Address - Country:US
Practice Address - Phone:787-620-5757
Practice Address - Fax:787-905-7921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12263261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0089684Medicare UPIN
PR0089350Medicare UPIN