Healthcare Provider Details
I. General information
NPI: 1205127032
Provider Name (Legal Business Name): ADVANCED ENDOSCOPY CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2011
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
471 AVE. FERROCARRIL SUITE #17
PONCE PR
00717
US
IV. Provider business mailing address
471 AVE. FERROCARRIL SUITE 135
PONCE PR
00717
US
V. Phone/Fax
- Phone: 787-843-1129
- Fax: 787-848-7979
- Phone: 787-843-1129
- Fax: 787-848-7979
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | 22 |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QE0800X |
| Taxonomy | Endoscopy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALVARO
REYMUNDE
Title or Position: PRESIDENTE
Credential: MD
Phone: 787-259-8212