Provider Demographics
NPI:1740579580
Name:HEALTH IMAGE DIAGNOSTICS, PSC
Entity Type:Organization
Organization Name:HEALTH IMAGE DIAGNOSTICS, PSC
Other - Org Name:SENOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:MS
Authorized Official - First Name:DINORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTELA JOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-474-0820
Mailing Address - Street 1:525 AVE FD ROOSEVELT
Mailing Address - Street 2:TORRE DE PLAZA LAS AMERICAS SUITE 403
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-8001
Mailing Address - Country:US
Mailing Address - Phone:787-523-0952
Mailing Address - Fax:
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:TORRE DE PLAZA LAS AMERICAS SUITE 403
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-523-0952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH IMAGE DIAGNOSTICS, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology