Imaging Development Corp

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

171164 Issued in PR

Legal business name

IMAGING DEVELOPMENT CORP

Practice address

C/42 S.E #1000
Reparto Metropolitano
San Juan, PR 00921

Phone

(787) 751-6400

Fax

(787) 523-1735

NPI assigned

Oct 23, 2007

Organization subpart

Yes

Parent organization

IMAGING DEVELOPMENT CORP AT LOIZA VALLEYAs reported in NPPES

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

Authorized official

Name

Fermin Guerra, CPA

Title

Administrador

Phone

(787) 645-7523

Specialties & licenses 2

Addresses

Part of

Imaging Development Corp

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1942499108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRAND BOULEVARD PASEOS",
            "address_2": "PMB 439 SUITE 112",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265902",
            "telephone_number": "787-751-6400",
            "fax_number": "787-523-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C/42 S.E #1000",
            "address_2": "REPARTO METROPOLITANO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-751-6400",
            "fax_number": "787-523-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING DEVELOPMENT CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMAGING DEVELOPMENT CORP AT LOIZA VALLEY",
        "enumeration_date": "2007-10-23",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "FERMIN",
        "authorized_official_title_or_position": "ADMINISTRADOR",
        "authorized_official_telephone_number": "787-645-7523",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "PR",
            "license": "171164",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "171164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ih Endo LLC
• Enrique Jose Illas Hernandez I, RN
• Damaris Illas, TECH.
• Imagenes Dinamicas, Inc.
• Imagenes Radiologicas del Caribe
• Winston Segundo Imbert de Iturrondo, MD
• Manuel E Imbert Garraton, MD
• Imca
• Imcs Holdings of PR
• Imi of San Juan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.