=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003148123
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GALOPE ANESTHESIA SERVICES CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2010
-----------------------------------------------------
Last Update Date | 02/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | DOCTOR' CENTER HOSPITAL SAN JUAN SAN RAFAEL 1395
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00910-3428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-626-5602
-----------------------------------------------------
Fax | 787-626-5602
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PASEO LOS CORALES I 576 MAR CARIBE
-----------------------------------------------------
City | DORADO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-626-5602
-----------------------------------------------------
Fax | 787-626-5602
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. ADALBERTO J LOPEZ I
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 787-626-5602
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 12198
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------