MEDICARE: URO-TECHNICAL SERVICES, PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	12899	PR

General Provider Information

NPI Number	:	1922391218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URO-TECHNICAL SERVICES, PSC

Provider Business Mailing Address
First Line	:	T3-8 CARR 21
Second Line	:	LAS LOMAS
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3312
Country	:	US
Telephone Number	:	787-781-1265
Fax Number	:

Provider Business Practice Location Address
First Line	:	T3-8 CARR 21
Second Line	:	LAS LOMAS
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3312
Country	:	US
Telephone Number	:	787-781-1265
Fax Number	:

Authorized Official
Title or Position	:	RESIDENT AGENT
Name	:	DR. LUIS R. AMBERT
Credential	:	MD
Telephone Number	:	787-781-1265

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	05/24/2011

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