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General NPI Number Information
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NPI Number | 1053300541
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ANESTHESIA PROVIDERS PSC
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | CALLE DE DIEGO E # 55 OFI 207 CPR BUILDING
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4866
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Country | US
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Telephone | 787-834-4347
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Fax | 787-265-7750
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Provider Business Mailing Address
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Address Line | PO BOX 939
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City | MAYAGUEZ
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State | PR
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Zip | 00681-0939
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Country | US
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Telephone | 787-834-4347
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Fax | 787-265-7750
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESUS BECERRA
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Credential | MD
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Telephone | 787-834-4347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 9473
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License Number State | PR
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