Provider Demographics
NPI:1053129536
Name:UTUADO SONOGRAPHY CENTER
Entity type:Organization
Organization Name:UTUADO SONOGRAPHY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVANIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:RIVERA SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-485-7162
Mailing Address - Street 1:HC 4 BOX 9213
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-7718
Mailing Address - Country:US
Mailing Address - Phone:787-485-7162
Mailing Address - Fax:
Practice Address - Street 1:79 CALLE DR CUETO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2804
Practice Address - Country:US
Practice Address - Phone:787-485-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5041721OtherID