Provider Demographics
NPI:1700870326
Name:MRI CENTER, LLC
Entity Type:Organization
Organization Name:MRI CENTER, LLC
Other - Org Name:MRI CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE VP
Authorized Official - Prefix:MS
Authorized Official - First Name:NORISELLE
Authorized Official - Middle Name:Z
Authorized Official - Last Name:RIVERA POL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-621-3724
Mailing Address - Street 1:PO BOX 602727
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-6037
Mailing Address - Country:US
Mailing Address - Phone:787-780-9069
Mailing Address - Fax:787-625-2626
Practice Address - Street 1:1815 RD 2
Practice Address - Street 2:CT RADIOLOGY COMPLEX
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7279
Practice Address - Country:US
Practice Address - Phone:787-780-9069
Practice Address - Fax:787-780-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 2085D0003X, 2085R0202X, 247100000X, 261QM1200X
PR2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)Group - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81059OtherTRIPLE S INC.