Provider Demographics
NPI:1518196302
Name:ISHO CORP.
Entity Type:Organization
Organization Name:ISHO CORP.
Other - Org Name:AIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:GUTFRAJND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-567-1117
Mailing Address - Street 1:PO BOX 1798
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1798
Mailing Address - Country:US
Mailing Address - Phone:787-734-9494
Mailing Address - Fax:787-734-9494
Practice Address - Street 1:CARR. 189 KM 12.7
Practice Address - Street 2:VILLA ANA MEDICAL AND PROFESSIONAL CENTER
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-734-9494
Practice Address - Fax:787-734-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology