Provider Demographics
NPI:1659696680
Name:SONO X RAY RADIOLOGY GROUP
Entity Type:Organization
Organization Name:SONO X RAY RADIOLOGY GROUP
Other - Org Name:QUADRANGLE IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUBRIEL-MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-746-1688
Mailing Address - Street 1:PO BOX 1778
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1778
Mailing Address - Country:US
Mailing Address - Phone:787-746-1688
Mailing Address - Fax:787-703-0010
Practice Address - Street 1:50 AVE L MUNOZ MARIN
Practice Address - Street 2:QUADRANGLE MEDICAL CENTER, SUITE 208
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3975
Practice Address - Country:US
Practice Address - Phone:787-746-1688
Practice Address - Fax:787-703-0010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SONO X RAY RADIOLOGY GROUO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82761OtherMEDICARE
PR81064OtherTRIPLE-S SALUD
PR81494OtherTRIPLE-S SALUD