Provider Demographics
NPI:1558460311
Name:CENTRO SONOGRAFICO DE ISABELA
Entity Type:Organization
Organization Name:CENTRO SONOGRAFICO DE ISABELA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHADO LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:787-872-3332
Mailing Address - Street 1:PO BOX 2563
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2005
Mailing Address - Country:US
Mailing Address - Phone:787-872-3332
Mailing Address - Fax:787-872-3332
Practice Address - Street 1:6 CALLE EDUARDO QUEVEDO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2617
Practice Address - Country:US
Practice Address - Phone:787-872-3332
Practice Address - Fax:787-872-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography