Healthcare Provider Details

I. General information

NPI: 1750135554
Provider Name (Legal Business Name): GHAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 AVE TITO CASTRO TORRE MEDICA SAN LUCAS SUITE #812
PONCE PR
00716
US

IV. Provider business mailing address

PO BOX 801179
COTO LAUREL PR
00780-1179
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-2604
  • Fax: 787-812-5279
Mailing address:
  • Phone: 787-812-2604
  • Fax: 787-812-5279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTOR JESUS TORRES ORTIZ
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 787-812-2604