Provider Demographics
NPI:1801119805
Name:SOCIEDAD DE RADIOLOGOS ISABELINOS,P.S.C.
Entity type:Organization
Organization Name:SOCIEDAD DE RADIOLOGOS ISABELINOS,P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-3131
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0845
Mailing Address - Country:US
Mailing Address - Phone:787-854-3131
Mailing Address - Fax:787-854-3235
Practice Address - Street 1:HOSPITAL BUEN SAMARITANO
Practice Address - Street 2:DEPARTAMENTO DE RADIOLOGIA-OFICINA DE RADIOLOGOS
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-0000
Practice Address - Country:US
Practice Address - Phone:787-624-0200
Practice Address - Fax:787-658-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4836174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5932OtherDEPARTAMENTO DE ESTADO