Provider Demographics
NPI:1588776090
Name:INTERNATIONAL MEDICAL CENTER CORP
Entity type:Organization
Organization Name:INTERNATIONAL MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHEVRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-288-8252
Mailing Address - Street 1:ST DE LA VERA D8
Mailing Address - Street 2:VILLA ESPANA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-288-8252
Mailing Address - Fax:787-786-8234
Practice Address - Street 1:D8 CALLE DE LA VERA
Practice Address - Street 2:VILLA ESPANA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7357
Practice Address - Country:US
Practice Address - Phone:787-288-8252
Practice Address - Fax:787-786-8234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty