1740912971 NPI number — CARIBBEAN IMAGING AND RADIATION TREATMENT CENTER,INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740912971 NPI number — CARIBBEAN IMAGING AND RADIATION TREATMENT CENTER,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN IMAGING AND RADIATION TREATMENT CENTER,INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740912971
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2225 PONCE BY PASS
Provider Second Line Business Mailing Address:
EDIFICIO PARRA SUITE 103
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00717-1320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-842-2478
Provider Business Mailing Address Fax Number:
787-841-2818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE PROLONGACION 25 DE JULIO
Provider Second Line Business Practice Location Address:
# 14
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-492-0260
Provider Business Practice Location Address Fax Number:
787-492-0265
Provider Enumeration Date:
06/27/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
ANGEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-842-2478

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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