Provider Demographics
NPI:1427245315
Name:CENTRO DE IMAGENES E INSTITUTO DE LA MUJER CRISTO REDENTOR
Entity type:Organization
Organization Name:CENTRO DE IMAGENES E INSTITUTO DE LA MUJER CRISTO REDENTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RABELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-864-4300
Mailing Address - Street 1:PO BOX 10011
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785
Mailing Address - Country:US
Mailing Address - Phone:787-864-4300
Mailing Address - Fax:787-864-4466
Practice Address - Street 1:URB. LA HACIENDA
Practice Address - Street 2:AVE. PEDRO ALBIZU CAMPOS
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:787-864-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology