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General NPI Number Information
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NPI Number | 1144842659
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Entity Type | Organization
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Legal Business Name | PR ONCOLOGY LLC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 08/16/2025
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Provider Practice Location Address
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Address Line | 97 AVE DE DIEGO
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City | SAN JUAN
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State | PR
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Zip | 00927-6310
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Country | US
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Telephone | 939-545-6353
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Fax | 939-545-6354
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Provider Business Mailing Address
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Address Line | 97 AVE DE DIEGO
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City | SAN JUAN
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State | PR
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Zip | 00927-6310
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Country | US
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Telephone | 787-919-7919
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Fax | 939-545-6354
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Authorized Official
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Title or Position | PRESIDENTE
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Name | LUIS BAEZ VALLECILLO
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Credential | MD
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Telephone | 939-545-6353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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