Provider Demographics
NPI:1023349339
Name:RADIOLOGIA DEL TURABO, C.S.P.
Entity type:Organization
Organization Name:RADIOLOGIA DEL TURABO, C.S.P.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONZALEZ SALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-746-1610
Mailing Address - Street 1:PO BOX 1778
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1778
Mailing Address - Country:US
Mailing Address - Phone:787-746-1610
Mailing Address - Fax:787-703-0010
Practice Address - Street 1:50 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:SUITES 207-209, 107-108, 103-104, 106
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3975
Practice Address - Country:US
Practice Address - Phone:787-746-1610
Practice Address - Fax:787-703-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QR0200X, 261QR0206X
2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1023349339OtherMMM
PR1023349339OtherHUMANA
PR1023349339OtherIMC
PR1023349339OtherCFSE
PR037931800Medicaid
PR1023349339OtherMAPFRE
PR1023349339OtherTRIPLE-S
PR1023349339OtherMCS
PR1023349339OtherMENONITA
PR1023349339OtherPMC
PR1023349339OtherACAA