Provider Demographics
NPI:1548572555
Name:ECOIMAGENES DE PUERTO RICO, CORP.
Entity Type:Organization
Organization Name:ECOIMAGENES DE PUERTO RICO, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LORENZO MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-830-7900
Mailing Address - Street 1:PO BOX 1842
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1842
Mailing Address - Country:US
Mailing Address - Phone:787-830-7900
Mailing Address - Fax:866-350-7282
Practice Address - Street 1:AVE. MILITAR KM. 112.9 SECTOR LA CURVA
Practice Address - Street 2:SUITE 101
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-0000
Practice Address - Country:US
Practice Address - Phone:787-830-7900
Practice Address - Fax:866-350-7282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty