Provider Demographics
NPI:1720474034
Name:RADIATION ONCOLOGY AND PSYCHIATRY SERVICES C.S.P.
Entity type:Organization
Organization Name:RADIATION ONCOLOGY AND PSYCHIATRY SERVICES C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALOU ABASOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-664-9538
Mailing Address - Street 1:39 CALLE SAN EDMUNDO
Mailing Address - Street 2:VILLA DE SAN IGNACIO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6438
Mailing Address - Country:US
Mailing Address - Phone:787-731-5785
Mailing Address - Fax:
Practice Address - Street 1:140 AVE LAS CUMBRES
Practice Address - Street 2:OFIC 201
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5523
Practice Address - Country:US
Practice Address - Phone:787-731-5785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR113792084P0800X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty