Healthcare Provider Details

I. General information

NPI: 1841068764
Provider Name (Legal Business Name): OBGYNIUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 AVE TITO CASTRO STE 102
PONCE PR
00716-4733
US

IV. Provider business mailing address

32 CALLE CEIBA MANSION DEL SUR
COTO LAUREL PR
00780
US

V. Phone/Fax

Practice location:
  • Phone: 787-651-6121
  • Fax:
Mailing address:
  • Phone: 787-585-7532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ZASKIA RODRIGUEZ GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-585-7532