Provider Demographics
NPI:1871726232
Name:INTERNATIONAL RADIOLOGY CENTER & MEDICAL PSC
Entity type:Organization
Organization Name:INTERNATIONAL RADIOLOGY CENTER & MEDICAL PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-999-5400
Mailing Address - Street 1:EDIF INTERNACIONAL DE MERCADEO PRIMER PISO
Mailing Address - Street 2:C-107
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-999-5400
Mailing Address - Fax:787-999-5401
Practice Address - Street 1:EDIF INTERNACIONAL DE MERCADEO
Practice Address - Street 2:C-107 PRIMER PISO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-999-5400
Practice Address - Fax:787-999-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology