# CENTRO DE RADIOTERAPIA AUXILIO MUTUO, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154379253
- **Authorized official:** MR. JORGE LUIS MATTA MHSA (ADMINISTRATOR)
- **Authorized official phone:** (787) 758-2000

## Contact information

- **Practice address:** 735 AVE PONCE DE LEON, STOP 37.5, SAN JUAN, PR 00917-5022
- **Practice address phone:** (787) 771-7934
- **Practice address fax:** (787) 771-7402
- **Mailing address:** PO BOX 191227, SAN JUAN, PR 00919-1227
- **Mailing address phone:** (787) 771-7934
- **Mailing address fax:** (787) 771-7402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 07/18/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 100593 | CRUZ AZUL | PR |
| 01 | — | 660312302 | MAPFRE | PR |
| 01 | — | 7582 | PALIC | PR |
| 01 | — | 9190184 | HUMANA | PR |