Healthcare Provider Details

I. General information

NPI: 1558277277
Provider Name (Legal Business Name): PULMONARY ALLIANCE OF PR,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GUAYNABO MEDICAL PLAZA SUITE 203 10 AVE LAS CUMBRES
GUAYNABO PR
00969-9998
US

IV. Provider business mailing address

H5 AVE SAN PATRICIO APT 1403
GUAYNABO PR
00968-3223
US

V. Phone/Fax

Practice location:
  • Phone: 787-679-2010
  • Fax:
Mailing address:
  • Phone: 787-679-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS R VAZQUEZ GONZALEZ
Title or Position: PRESIDENTE
Credential: MD
Phone: 787-679-2010