Organization
NEURO RADIO SURGERY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ENID L CRESPO (BILLING SUPERVISION)
(787) 834-6070
Entity
Organization
Contact information
Practice address
CARR 2, CENTRO MEDICO RAMON E. BETANCES, MAYAGUEZ, PR 00682-6353
(787) 834-6070
(787) 834-5535
Mailing address
PO BOX 8043, MARINA STATION, MAYAGUEZ, PR 00681-8043
(787) 834-6070
(787) 834-5535
Taxonomy
Speciality
Code
Description
License number
State
2471R0002X
Radiation Therapy Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048900
TRIPLE S
PR
01
—
47-21052
PLAN DE SALUD U.I.A. INC.
PR
01
—
510016
PREFERRED HEALTH
PR
01
—
6820006
HUMANA
PR
Enumeration date
11/01/2006
Last updated
10/08/2008
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