Healthcare Provider Details

I. General information

NPI: 1780448845
Provider Name (Legal Business Name): GRUPO DE ANESTESIOLOGIA LAS LOMAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR #2 KM 173.4 BO CAIN ALTO
SAN GERMAN PR
00683-0000
US

IV. Provider business mailing address

246 CALLE MIRAMAR
CABO ROJO PR
00623-9004
US

V. Phone/Fax

Practice location:
  • Phone: 787-368-1816
  • Fax: 787-892-4500
Mailing address:
  • Phone: 787-368-1816
  • Fax: 787-892-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL ALTIERI ACEVEDO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-368-1816