Provider Demographics
NPI:1962728568
Name:EL SENORIAL CENTRO DE IMAGENES
Entity type:Organization
Organization Name:EL SENORIAL CENTRO DE IMAGENES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACTURADORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISTUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-764-9493
Mailing Address - Street 1:PO BOX 363247
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1755 CALLE PARANA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6049
Practice Address - Country:US
Practice Address - Phone:787-764-9493
Practice Address - Fax:787-759-3621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL SENORIAL CENTRO DE IMAGENES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084899Medicare PIN