Provider Demographics
NPI:1821483587
Name:HATO REY X-RAY AND IMAGING CENTER INC.
Entity Type:Organization
Organization Name:HATO REY X-RAY AND IMAGING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-754-1422
Mailing Address - Street 1:35 CALLE JUAN C BORBON STE 67
Mailing Address - Street 2:PMB 368
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5375
Mailing Address - Country:US
Mailing Address - Phone:787-754-1422
Mailing Address - Fax:787-754-8555
Practice Address - Street 1:156 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-754-1422
Practice Address - Fax:787-754-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QM1200X, 261QR0200X, 261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography