# INNOVATIVE MEDICAL AND RADIOLOGY MANAGEMENT

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

## Provider details

- **NPI number:** 1992998785
- **Authorized official:** DR. JUAN CARLOS DEL RIO ROURE M.D. (PRESIDENT)
- **Authorized official phone:** (787) 730-1166

## Contact information

- **Practice address:** CARR. 165 KM 8.1, TOA ALTA, PR 00953
- **Practice address phone:** (787) 730-1166
- **Mailing address:** 162 CALLE BEGONIA, CIUDAD JARDIN 2, TOA ALTA, PR 00953-4855
- **Mailing address phone:** (787) 730-1166
- **Mailing address fax:** (787) 746-1425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/24/2007
- **Last updated:** 08/24/2007