Grupo Radioterapia del Norte
Organization Active NPI Radiation Therapy Radiologic Technologist · Manat, PR
NPI 1104815737 · NPPES record last updated Dec 4, 2008
Key facts
- NPI
- 1104815737
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiation Therapy Radiologic Technologist 2471R0002X
- Legal business name
- GRUPO RADIOTERAPIA DEL NORTE
- Practice address
- Road #2 KM 47.7
Manat, PR 00674 - Phone
- (787) 621-0021
- Fax
- (787) 621-0023
- NPI assigned
- Oct 17, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Carlos M. Chevere, M.D.
- Title
- Predident
- Phone
- (787) 621-0021
Practitioners 3
-
Carlos M Chevere, M.D.
-
Julio J Diaz, M.D.
-
Ricardo Lopez Mujica, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060210000016 | PR | Part B Supplier - Clinic/Group Practice | 9335154400 |
Receives reassigned benefits from 2 practitioners Practice locations: Manati, PR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Therapy Radiologic Technologist |
2471R0002X | Yes |
Addresses
Primary practice location
Road #2 KM 47.7
Manat, PR 00674
Mailing address
PMB 298
PO Box 30500
Manati, PR 00674
Phone (787) 621-0021
Other providers in Manat, PR
All providers in Manat, PR · Radiation Therapy Radiologic Technologist in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.