# PREMIER NUCLEAR MEDICINE CSP

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

## Provider details

- **NPI number:** 1295017010
- **Authorized official:** MARIA E ACEVEDO MD (PRESIDENT)
- **Authorized official phone:** (787) 402-0100

## Contact information

- **Practice address:** HOSPITAL RYDER MEMORIAL, 355 CALLE FONT MARTELO, HUMACAO, PR 00791-3249
- **Practice address phone:** (787) 850-2012
- **Practice address fax:** (787) 850-2012
- **Mailing address:** URBANIZACION SANTA ROSA, CALLE 9 BLQ 17 NO 17, BAYAMON, PR 00959-6606
- **Mailing address phone:** (787) 402-0100
- **Mailing address fax:** (787) 294-6099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207UN0902X | Nuclear Imaging & Therapy Physician | 10641 | PR | Yes |

## Other

- **Enumeration date:** 09/19/2011
- **Last updated:** 06/01/2020