Healthcare Provider Details

I. General information

NPI: 1942695788
Provider Name (Legal Business Name): MSA CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B2 DR. RAMOS MIMOSO STREET
GUAYNABO PR
00966
US

IV. Provider business mailing address

B2 RAMOS MIMOSO ST. GARDEN HILLS VILLAS
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-525-0400
  • Fax:
Mailing address:
  • Phone: 787-525-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS RODRIGUEZ-ESCOLA
Title or Position: SURGEON/PRESIDENT
Credential: MD
Phone: 787-525-0400