Provider Demographics
NPI:1902927015
Name:CENTRO IMAGENES BELLA VISTA
Entity Type:Organization
Organization Name:CENTRO IMAGENES BELLA VISTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CANDIDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PINEIRO CRISTOBAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-730-4542
Mailing Address - Street 1:PO BOX 4292
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958-1292
Mailing Address - Country:US
Mailing Address - Phone:787-730-4542
Mailing Address - Fax:787-730-4542
Practice Address - Street 1:CENTRO COMERCIAL BELLA VISTA
Practice Address - Street 2:OFICINA 20-A LOCAL 4
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-730-4542
Practice Address - Fax:787-730-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR247100000X, 2471B0102X, 2471C3402X, 2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
Not Answered2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty
Not Answered2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty
Not Answered2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9580003OtherHUMANA
PR0022537OtherSSS
PR100186OtherLA CRUZ AZUL DE PR
PR8957OtherFIRST PLUS
PR100186OtherLA CRUZ AZUL DE PR
PR=========OtherCIGNA
PR=========OtherCOSVI
PR9580003OtherHUMANA
PR=========OtherMAPFRE
PR8957Medicare ID - Type UnspecifiedFIRST PLUS ADVANTAGE
PR810094Medicare ID - Type UnspecifiedMEDICARE MUCHO MAS
PR8957OtherFIRST PLUS
PR=========OtherAMERICAN HEALTH
PR0022537OtherSSS
PR961Medicare ID - Type UnspecifiedAMERICAL HEALTH MEDICARE
PR=========OtherCIGNA