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Organization

LAZOS RADIOLOGY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. WILMA CORDERO GINES (MANAGER)
(787) 727-0500
Entity
Organization

Contact information

Practice address
611 CALLE MANUEL PAVIA, PAVIA MEDICAL PLAZA, SUITE 113, SAN JUAN, PR 00910
(787) 727-0500
(787) 268-5511
Mailing address
PO BOX 11792, SAN JUAN, PR 00910-2892
(787) 727-0500
(787) 268-5511

Taxonomy

Speciality
Code
Description
License number
State
2471B0102X
Bone Densitometry Radiologic Technologist
2471C3401X
Computed Tomography Radiologic Technologist
2471C3402X
Radiography Radiologic Technologist
2471M2300X
Mammography Radiologic Technologist
Primary
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
2471S1302X
Sonography Radiologic Technologist
2471V0105X
Vascular Sonography Radiologic Technologist

Other

Enumeration date
08/21/2017
Last updated
08/21/2017
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