Basic Information
| Provider Information | |||||||||
| NPI: | 1033289624 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN RADIOLOGY AND CARDIOVASCULAR INST. OF THE SAN ANTONIO PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1019 | ||||||||
| Address2: | |||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006811019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878340050 | ||||||||
| FaxNumber: | 7878312104 | ||||||||
| Practice Location | |||||||||
| Address1: | 18 CALLE POST N | ||||||||
| Address2: | |||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006806626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878340050 | ||||||||
| FaxNumber: | 7878312104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LUGO OLIVIERI | ||||||||
| AuthorizedOfficialFirstName: | CARLOS | ||||||||
| AuthorizedOfficialMiddleName: | HERNAN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7878340050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 12412 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.