Organization
CENTRO MEDICO DEL TURABO INC
Active
Organization
CENTRO MEDICO DEL TURABO INC
Active
Other names
GRUPO RADIOLOGIA FAJARDO
Organization subpart
No
Provider details
NPI number
Authorized official
ORLANDO RIVERA LCDO (EXECUTIVE DIRECTOR)
(787) 653-3434
Entity
Organization
Contact information
Practice address
HIMA SAN PABLO FAJARDO, AVE GENERAL VALERO 404, FAJARDO, PR 00738
(787) 655-0505
(787) 655-5086
Mailing address
PO BOX 4980, CAGUAS, PR 00726
(787) 653-3434
(787) 961-1901
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12167
MEDICAL LICENSE
PR
01
—
4101
MEDICAL LICENSE
PR
01
—
8383
MEDICAL LICENSE
PR
01
—
8418
MEDICAL LICENSE
PR
Enumeration date
05/10/2007
Last updated
08/12/2013
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