Provider Demographics
NPI:1811005812
Name:SIMED DIAGNOSTIC GROUP CORP
Entity Type:Organization
Organization Name:SIMED DIAGNOSTIC GROUP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:MS
Authorized Official - First Name:ZUZEL
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:CANTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-368-5010
Mailing Address - Street 1:PMB 152 AVE. ESMERALDA #53
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4429
Mailing Address - Country:US
Mailing Address - Phone:787-778-8659
Mailing Address - Fax:
Practice Address - Street 1:AVE. AGUAS BUENAS #1630
Practice Address - Street 2:URB. SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6652
Practice Address - Country:US
Practice Address - Phone:787-368-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty