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Contact Information

INNOVATIVE INTERVENTIONAL RADIOLOGY IMAGING
COND ANDREAS COURT
370 CALLE 10 APT 146
TRUJILLO ALTO, PR00976
 Phone: 787-761-7477
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for INNOVATIVE INTERVENTIONAL RADIOLOGY IMAGING

NPI Number 1710299722
LBN Legal business name INNOVATIVE INTERVENTIONAL RADIOLOGY IMAGING
Authorized official IVELISSE CANCEL - (VICEPRESIDENT/ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2010
Last updated 07/07/2010 - About 16 years ago
Identifiers
PR License # 14053
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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