Organization
GUAYNABO HEALTH PROVIDERS, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIANA MEDINA OTERO (PRESIDENT)
(787) 720-5050
Entity
Organization
Contact information
Practice address
140 AVE LAS CUMBRES, GUAYNABO MEDICAL MALL, GUAYNABO, PR 00969-5523
(787) 720-5050
(787) 720-4949
Mailing address
PMB 205 PO BOX 70344, SAN JUAN, PR 00936-8344
(787) 720-5050
(787) 720-4949
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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