Organization
CENTRO DE RADIOTERAPIA AUXILIO MUTUO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE LUIS MATTA MHSA (ADMINISTRATOR)
(787) 758-2000
Entity
Organization
Contact information
Practice address
735 AVE PONCE DE LEON, STOP 37.5, SAN JUAN, PR 00917-5022
(787) 771-7934
(787) 771-7402
Mailing address
PO BOX 191227, SAN JUAN, PR 00919-1227
(787) 771-7934
(787) 771-7402
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100593
CRUZ AZUL
PR
01
—
660312302
MAPFRE
PR
01
—
7582
PALIC
PR
01
—
9190184
HUMANA
PR
Enumeration date
05/04/2006
Last updated
07/18/2016
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