Provider Demographics
NPI:1972721777
Name:CENTRO DE DIAGNOSTICO Y TRATAMIENTO LAS PIEDRAS
Entity type:Organization
Organization Name:CENTRO DE DIAGNOSTICO Y TRATAMIENTO LAS PIEDRAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:787-771-2100
Mailing Address - Street 1:P O BOX 8548
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-733-8969
Mailing Address - Fax:787-716-0055
Practice Address - Street 1:CARR. 198 KM.22.2
Practice Address - Street 2:BO. MONTONES 1
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-733-8969
Practice Address - Fax:787-716-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR48261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR030713OtherE R
PRS666OtherE R
PR09202OtherE R
PR6000275OtherE R
PR40151OtherE R
PR00379OtherE R
PR1000381OtherE R
PR19110OtherE R
PR6604263425LOtherE R
PR7710016OtherE R
PRSH00802OtherE R
PR=========LPOtherE R
PRS666OtherE R
PR030713OtherE R