Provider Demographics
NPI:1710350921
Name:X RAY PENUELAS
Entity Type:Organization
Organization Name:X RAY PENUELAS
Other - Org Name:PENUELAS X RAY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-533-4518
Mailing Address - Street 1:907 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-1401
Mailing Address - Country:US
Mailing Address - Phone:787-836-4800
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:907 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-1401
Practice Address - Country:US
Practice Address - Phone:787-836-4800
Practice Address - Fax:787-848-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography