Provider Demographics
NPI:1669289393
Name:ERAD, LLC
Entity type:Organization
Organization Name:ERAD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIAGNOSTIC RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-501-0464
Mailing Address - Street 1:84 URB LAKEVIEW EST
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3320
Mailing Address - Country:US
Mailing Address - Phone:787-501-0464
Mailing Address - Fax:
Practice Address - Street 1:84 URB LAKEVIEW EST
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3320
Practice Address - Country:US
Practice Address - Phone:787-501-0464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty