Provider Demographics
NPI:1437313749
Name:PONCE NEURORADIOLOGICAL SERVICES, PSC
Entity Type:Organization
Organization Name:PONCE NEURORADIOLOGICAL SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIZARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-795-4321
Mailing Address - Street 1:PMB 358 1353 ROAD 19
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-795-4321
Mailing Address - Fax:
Practice Address - Street 1:PMB 358 1353 ROAD 19
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-795-4321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR110212085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty