Provider Demographics
NPI:1720303522
Name:CARIBBEAN NEURORADIOLOGY SERVICES, INC.
Entity Type:Organization
Organization Name:CARIBBEAN NEURORADIOLOGY SERVICES, INC.
Other - Org Name:PONCE MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REMY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-841-1730
Mailing Address - Street 1:CENTRO CARIBE 103
Mailing Address - Street 2:PONCE BY PASS 2053
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1307
Mailing Address - Country:US
Mailing Address - Phone:787-984-1000
Mailing Address - Fax:787-841-1725
Practice Address - Street 1:SAN JORGE MALL
Practice Address - Street 2:CALLE DAMAS, PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-984-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARIBBEAN NEURORADIOLOGY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty