Provider Demographics
NPI:1891867032
Name:ADVANCED MEDICAL INSTITUTE OF THE CARIBBEAN INC.
Entity Type:Organization
Organization Name:ADVANCED MEDICAL INSTITUTE OF THE CARIBBEAN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:HERNAN
Authorized Official - Last Name:LUGO OLIVIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-805-1552
Mailing Address - Street 1:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1019
Mailing Address - Country:US
Mailing Address - Phone:787-805-1552
Mailing Address - Fax:787-834-2676
Practice Address - Street 1:CARR 349 KM 2.7 CERRO LAS MESAS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-805-1552
Practice Address - Fax:787-834-2676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2010-05-17
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2010-05-17
Provider Licenses
StateLicense IDTaxonomies
PR124122471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherSSN