Provider Demographics
NPI:1740409481
Name:CENTRO DE DIAGNOSTICO Y TRATAMIENTO
Entity Type:Organization
Organization Name:CENTRO DE DIAGNOSTICO Y TRATAMIENTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALCALDE
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:AUBIN
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-854-2292
Mailing Address - Street 1:10 CALLE QUINONES
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5013
Mailing Address - Country:US
Mailing Address - Phone:787-854-2292
Mailing Address - Fax:787-854-2092
Practice Address - Street 1:CARR. # 2 K. 50.0
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-2292
Practice Address - Fax:787-854-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherMCS