Healthcare Provider Details

I. General information

NPI: 1750429890
Provider Name (Legal Business Name): ATENAS LITOTRIPSY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL DOCTO'S CENTER CARR. 2, KM. 47.4
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 1442
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3318
  • Fax: 787-621-3342
Mailing address:
  • Phone: 787-621-3318
  • Fax: 787-621-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS VIERA CABAN
Title or Position: PRESIDENTE
Credential: M.D.
Phone: 787-621-3318