Organization
PREMIER NUCLEAR MEDICINE CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA E ACEVEDO MD (PRESIDENT)
(787) 402-0100
Entity
Organization
Contact information
Practice address
HOSPITAL RYDER MEMORIAL, 355 CALLE FONT MARTELO, HUMACAO, PR 00791-3249
(787) 850-2012
(787) 850-2012
Mailing address
URBANIZACION SANTA ROSA, CALLE 9 BLQ 17 NO 17, BAYAMON, PR 00959-6606
(787) 402-0100
(787) 294-6099
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
10641
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FC340A
MEDICARE PTAN
PR
Enumeration date
09/19/2011
Last updated
06/01/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up