Provider Demographics
NPI:1861715278
Name:CENTRO RADIOLOGICO ROLON
Entity type:Organization
Organization Name:CENTRO RADIOLOGICO ROLON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:787-879-0750
Mailing Address - Street 1:PO BOX 142292
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-2292
Mailing Address - Country:US
Mailing Address - Phone:787-879-0749
Mailing Address - Fax:787-816-4307
Practice Address - Street 1:152 AVE MUNOZ RIVERA OESTE
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2309
Practice Address - Country:US
Practice Address - Phone:787-820-2122
Practice Address - Fax:787-820-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography