Provider Demographics
NPI:1366884090
Name:CENTO DE IMAGEN-RADIOLOGIA DIGITAL OMIAN INC.
Entity type:Organization
Organization Name:CENTO DE IMAGEN-RADIOLOGIA DIGITAL OMIAN INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:OMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-381-4665
Mailing Address - Street 1:159 PASEO TORRE ALTA
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-9444
Mailing Address - Country:US
Mailing Address - Phone:787-381-4665
Mailing Address - Fax:
Practice Address - Street 1:61 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3027
Practice Address - Country:US
Practice Address - Phone:787-381-4665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology