Provider Demographics
NPI:1922347376
Name:NUSCAN AIBONITO
Entity Type:Organization
Organization Name:NUSCAN AIBONITO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HIRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-744-5278
Mailing Address - Street 1:PO BOX 6960
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6960
Mailing Address - Country:US
Mailing Address - Phone:787-744-5278
Mailing Address - Fax:
Practice Address - Street 1:120 CALLE JOSE C VAZQUEZ
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3309
Practice Address - Country:US
Practice Address - Phone:787-744-5278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NUSCAN CSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9549207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Single Specialty