MMD Advanced Imaging, PSC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

17175 Issued in PR

Legal business name

MMD ADVANCED IMAGING, PSC

Practice address

Plaza Las Americas Tower
Suite 905
San Juan, PR 00918

Phone

(787) 620-4316

NPI assigned

Mar 15, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mayra Maldonado-Duran, MD

Title

President

Phone

(787) 250-8985

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464480000000",
    "number": "1255630380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PLAZA LAS AMERICAS TOWER",
            "address_2": "SUITE 905",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-620-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA LAS AMERICAS TOWER",
            "address_2": "SUITE 905",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-620-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMD ADVANCED IMAGING, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2016-05-29",
        "status": "A",
        "authorized_official_last_name": "MALDONADO-DURAN",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-250-8985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "17175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Diagnostic Radiology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.