Provider Demographics
NPI:1952884702
Name:PLG BREAST IMAGING SERVICES, PSC
Entity Type:Organization
Organization Name:PLG BREAST IMAGING SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONZALEZ-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DABR
Authorized Official - Phone:787-298-5618
Mailing Address - Street 1:SENDERO ESTATES
Mailing Address - Street 2:10 SENDERO DRIVE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-298-5618
Mailing Address - Fax:
Practice Address - Street 1:SENDERO ESTATES
Practice Address - Street 2:10 SENDERO DRIVE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-298-5618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty