Provider Demographics
NPI:1396723490
Name:CENTRO DE IMAGENES SONOGRAFICAS
Entity type:Organization
Organization Name:CENTRO DE IMAGENES SONOGRAFICAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-736-0980
Mailing Address - Street 1:HC 20 BOX 29194
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-9634
Mailing Address - Country:US
Mailing Address - Phone:787-736-0980
Mailing Address - Fax:787-736-4226
Practice Address - Street 1:PLAZA BUXO LOCAL 4B CARR 181 INT 183
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-736-0980
Practice Address - Fax:787-736-4226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR231802085R0202X, 2085U0001X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81493OtherTRIPLE S
81493Medicare UPIN
PR81493Medicare ID - Type Unspecified