Provider Demographics
NPI:1679772313
Name:MONTEHIDRA X RAY
Entity Type:Organization
Organization Name:MONTEHIDRA X RAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALDUONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-596-1118
Mailing Address - Street 1:MONTEHEIDRA TOWN CTR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7007
Mailing Address - Country:US
Mailing Address - Phone:787-708-5000
Mailing Address - Fax:
Practice Address - Street 1:MONTEHEIDRA TOWN CTR
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7007
Practice Address - Country:US
Practice Address - Phone:787-708-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5340261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5340OtherLICENSE