Healthcare Provider Details

I. General information

NPI: 1114132586
Provider Name (Legal Business Name): VOICE & SINUS INSTITUTE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 AVE PONCE DE LEON TORRE MEDICA DE AUXILIO MUTUO SUITE 214
SAN JUAN PR
00917-5022
US

IV. Provider business mailing address

735 PONCE DE LEON AVE TORRE MEDICA AUXILIO MUTUO SUITE 214
SAN JUAN PR
00917
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-1900
  • Fax: 787-766-2057
Mailing address:
  • Phone: 787-766-1900
  • Fax: 787-766-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number12433
License Number StatePR

VIII. Authorized Official

Name: DR. OMAR GONZALEZ - YANES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-766-1900