# CLINICA YAGUEZ INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CENTRO RADIOLOGICO PAVIA HEALTH CLINIC ANASCO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063055796
- **Authorized official:** CARLOS I HUERTAS (FINANCE DIRECTOR)
- **Authorized official phone:** (787) 832-8444

## Contact information

- **Practice address:** 1 CARR 402 ZONA INDUSTRIAL, BO MARIAS, ANASCO, PR 00610-2017
- **Practice address phone:** (787) 832-8444
- **Practice address fax:** (787) 805-2840
- **Mailing address:** PO BOX 698, MAYAGUEZ, PR 00681-0698
- **Mailing address phone:** (787) 832-8444
- **Mailing address fax:** (787) 805-2840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2019
- **Last updated:** 04/21/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0084907 | 0084907 | PR |
| 01 | — | GI092A | GI092A | PR |