Healthcare Provider Details
I. General information
NPI: 1669319455
Provider Name (Legal Business Name): ADVANCED ENDOCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 AVE SAN PATRICIO STE 1090
GUAYNABO PR
00968-3047
US
IV. Provider business mailing address
17-13 CALLE 10
BAYAMON PR
00959-6605
US
V. Phone/Fax
- Phone: 787-414-8777
- Fax:
- Phone: 787-414-8777
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRISTINA
M
CASAS LOYOLA
Title or Position: PRESIDENT
Credential:
Phone: 787-414-8777