Healthcare Provider Details

I. General information

NPI: 1679307060
Provider Name (Legal Business Name): PRSPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE WASHINGTON STE 308
SAN JUAN PR
00907-1509
US

IV. Provider business mailing address

29 CALLE WASHINGTON STE 308
SAN JUAN PR
00907-1509
US

V. Phone/Fax

Practice location:
  • Phone: 787-432-6591
  • Fax:
Mailing address:
  • Phone: 787-432-6591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS G MARRERO PEREZ
Title or Position: DR
Credential: MD
Phone: 787-432-6591