Provider Demographics
NPI:1528308970
Name:PATILLAS X-RAY
Entity type:Organization
Organization Name:PATILLAS X-RAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ RADIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BADILLO RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-839-2777
Mailing Address - Street 1:PO BOX 10007
Mailing Address - Street 2:SUITE 417
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-4007
Mailing Address - Country:US
Mailing Address - Phone:787-839-2777
Mailing Address - Fax:
Practice Address - Street 1:26 CALLE RIEFKOHL
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-2836
Practice Address - Country:US
Practice Address - Phone:787-839-2777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUAYAMA DIAGNOSTICS CSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology