Healthcare Provider Details

I. General information

NPI: 1629994611
Provider Name (Legal Business Name): ADVANCED COLORECTAL PR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CARR 696
DORADO PR
00646-5718
US

IV. Provider business mailing address

115 AVE ARTERIAL HOSTOS APT T1
SAN JUAN PR
00918-2995
US

V. Phone/Fax

Practice location:
  • Phone: 787-625-5050
  • Fax: 787-625-1080
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA C SCHOENE RUIZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-625-5050