Provider Demographics
NPI:1407850738
Name:STEREOTACTIC BREAST CENTER PSC
Entity Type:Organization
Organization Name:STEREOTACTIC BREAST CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ZENAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-740-2120
Mailing Address - Street 1:P. O. BOX 9003
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8038
Mailing Address - Country:US
Mailing Address - Phone:787-740-3500
Mailing Address - Fax:787-995-6887
Practice Address - Street 1:BAYAMON MEDICAL PLZ
Practice Address - Street 2:STE 201
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-740-3500
Practice Address - Fax:787-995-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical