Provider Demographics
NPI:1619112810
Name:TESLA IMAGENES, CSP
Entity Type:Organization
Organization Name:TESLA IMAGENES, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-613-5513
Mailing Address - Street 1:PO BOX 361525
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1525
Mailing Address - Country:US
Mailing Address - Phone:787-613-5513
Mailing Address - Fax:787-977-2528
Practice Address - Street 1:PEDRO ALBIZU CAMPOS AVE
Practice Address - Street 2:HOSPITAL EPISCOPAL CRISTO REDENTOR
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-977-2525
Practice Address - Fax:787-977-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty