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General NPI Number Information
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NPI Number | 1033513239
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Entity Type | Organization
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Legal Business Name | PR UROLOGY GROUP PSC
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Dates
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Enumeration Date | 10/16/2014
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 746 AVE HOSTOS
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City | MAYAGUEZ
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State | PR
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Zip | 00682-1538
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Country | US
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Telephone | 787-834-8160
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Fax | 787-265-5777
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Provider Business Mailing Address
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Address Line | 746 AVE HOSTOS
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City | MAYAGUEZ
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State | PR
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Zip | 00682-1538
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Country | US
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Telephone | 787-834-8160
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Fax | 787-265-5777
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM ROMAN-TORREGUITART
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Credential | MD
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Telephone | 787-834-8160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 14210
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License Number State | PR
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