Basic Information
| Provider Information | |||||||||
| NPI: | 1831340926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LABAT ALVAREZ | ||||||||
| FirstName: | EDUARDO | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5900 AVE ISLA VERDE | ||||||||
| Address2: | L2 PMB 297 | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009795746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
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| Practice Location | |||||||||
| Address1: | ADMINISTRACION DE SERVICIOS MEDICOS DE PUERTO RICO | ||||||||
| Address2: | RCM-RADIOLOGIA, CARR.22, BO. MONACILLOS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009350001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
| FaxNumber: | 7877773855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2008 | ||||||||
| LastUpdateDate: | 06/01/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | 17841 | PR | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | 17841 | PR | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 17841 | 01 | PR | PUERTO RICO MEDICAL LICENSE | OTHER |