Provider Demographics
NPI:1063695534
Name:CENTRO IMAGENES DE BARRANQUITAS INC
Entity type:Organization
Organization Name:CENTRO IMAGENES DE BARRANQUITAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARATINI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-857-2141
Mailing Address - Street 1:PMB 101 1353
Mailing Address - Street 2:RD 19
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2700
Mailing Address - Country:US
Mailing Address - Phone:787-857-2141
Mailing Address - Fax:
Practice Address - Street 1:CARR 152 KM 8.0
Practice Address - Street 2:BO QUEBRADILLAS
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR169627291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory