Organization
ONCOLOGY & BODY IMAGING PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORY BALLESTER ORTIZ MD (PRESIDENT)
(787) 630-4735
Entity
Organization
Contact information
Practice address
735 AVE PONCE DE LEON, SAN JUAN, PR 00917-5022
(787) 758-2000
(787) 771-7927
Mailing address
PO BOX 435, ADJUNTAS, PR 00601-0435
(787) 630-4735
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
02/24/2020
Last updated
03/10/2020
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