Provider Demographics
NPI:1447285085
Name:METROPOLITAN MRI, ASSOC
Entity type:Organization
Organization Name:METROPOLITAN MRI, ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-781-0058
Mailing Address - Street 1:PMB 346
Mailing Address - Street 2:405 ESMERALDA AVE. SUITE 2
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-781-0058
Mailing Address - Fax:787-782-9971
Practice Address - Street 1:AVE. FRAGOSO #4 A S-4 Y 5
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00919-1058
Practice Address - Country:US
Practice Address - Phone:787-757-0572
Practice Address - Fax:787-757-6619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084690Medicare ID - Type Unspecified