Provider Demographics
NPI:1558771535
Name:RADIOLOGOS DEL SUR, LLC
Entity Type:Organization
Organization Name:RADIOLOGOS DEL SUR, LLC
Other - Org Name:JORGE L.TORRES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-844-8510
Mailing Address - Street 1:8169 CALLE CONCORDIA
Mailing Address - Street 2:COND. SAN VICENTE SUITE 1
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1554
Mailing Address - Country:US
Mailing Address - Phone:787-844-8510
Mailing Address - Fax:787-813-2779
Practice Address - Street 1:8169 CALLE CONCORDIA
Practice Address - Street 2:COND. SAN VICENTE SUITE 1
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1554
Practice Address - Country:US
Practice Address - Phone:787-844-8510
Practice Address - Fax:787-813-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9822261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82681Medicare PIN