# MEDICAL ANCILLARY DIAGNOSTIC SERVICES

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

## Provider details

- **NPI number:** 1629192471
- **Authorized official:** MR. HERIBERTO MORALES (PRESIDENT)
- **Authorized official phone:** (787) 261-5173

## Contact information

- **Practice address:** AVE BOULEVARD EE20, LEVITTOWN, TOA BAJA, PR 00949-5900
- **Practice address phone:** (787) 261-5173
- **Practice address fax:** (787) 261-2953
- **Mailing address:** 4633 AVE ISLA VERDE, COND CASTILLO DEL MAR PMB 1409, CAROLINA, PR 00979-5300
- **Mailing address phone:** (787) 261-5173
- **Mailing address fax:** (787) 261-2953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246Z00000X | Other Specialist/Technologist | 0087889 | PR | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 06/18/2008