Provider Demographics
NPI:1427338706
Name:PONCE NUCLEAR MEDICINE, P.S.C.
Entity type:Organization
Organization Name:PONCE NUCLEAR MEDICINE, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-922-8418
Mailing Address - Street 1:PO BOX 9570
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9570
Mailing Address - Country:US
Mailing Address - Phone:787-922-8418
Mailing Address - Fax:
Practice Address - Street 1:2213 BYPASS
Practice Address - Street 2:HOSPITAL DAMAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1318
Practice Address - Country:US
Practice Address - Phone:787-840-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology