Provider Demographics
NPI:1356531941
Name:GRUPO DE RADIOTERAPIA DEL TURABO, PSC
Entity type:Organization
Organization Name:GRUPO DE RADIOTERAPIA DEL TURABO, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIAZ PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-754-0315
Mailing Address - Street 1:PMB 10
Mailing Address - Street 2:PO BOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-754-0315
Mailing Address - Fax:787-763-9871
Practice Address - Street 1:AVE LUIS MUNOZ MARIN # 100
Practice Address - Street 2:URB MARIOLGA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-4081
Practice Address - Country:US
Practice Address - Phone:787-754-0315
Practice Address - Fax:787-763-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10907OtherSTATE LIC
PR15470OtherSTATE LIC
PR10670OtherSTATE LIC