Provider Demographics
NPI:1487895314
Name:CDT CENTRO DE SERVICIOS MEDICOS INTEGRADOS INC.
Entity type:Organization
Organization Name:CDT CENTRO DE SERVICIOS MEDICOS INTEGRADOS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:CANDELAS RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-778-0315
Mailing Address - Street 1:PO BOX 6598
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-5598
Mailing Address - Country:US
Mailing Address - Phone:787-778-0315
Mailing Address - Fax:787-778-0330
Practice Address - Street 1:59 CALLE SANTA CRUZ
Practice Address - Street 2:4TO PISO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6900
Practice Address - Country:US
Practice Address - Phone:787-778-0315
Practice Address - Fax:787-778-0330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CDT CENTRO DE SERVICIOS MEDICOS INTEGRADOS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR92291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory