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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