Organization Active NPI

Dynamic MRI and 3D CT CSP

  • Radiology Clinic/Center
  • Guaynabo, PR
National Provider Identifier
1790915221
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
DYNAMIC MRI AND 3D CT CSP
Practice address
6 Calle Carazo
Guaynabo, PR 00969-5613
Phone
(787) 272-0668
Fax
(787) 708-2588
NPI assigned
Jul 17, 2009
Last updated
Oct 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Mrs. Nidza Cordoves
Title
Administrator
Phone
(787) 272-3182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

6 Calle Carazo
Guaynabo, PR 00969-5613

Mailing address

PMB 336
405 Ave Esmeralda Ste 2
Guaynabo, PR 00969-4457
Phone (787) 272-3182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111021000442 PR Part B Supplier - Clinic/Group Practice 2961675764 Receives reassigned benefits from 1 practitioner
Practice locations: Guaynabo, PR

National Provider Directory

National Provider Directory

Locations

6 Calle Carazo
Guaynabo, PR 00969
Phone (787) 272-0668

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1790915221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 336",
            "address_2": "405 AVE ESMERALDA STE 2",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694457",
            "telephone_number": "787-272-3182",
            "fax_number": "787-708-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695613",
            "telephone_number": "787-272-0668",
            "fax_number": "787-708-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC MRI AND 3D CT CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "CORDOVES",
        "authorized_official_first_name": "NIDZA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-272-3182",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.