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General NPI Number Information
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NPI Number | 1194145235
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Entity Type | Organization
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Legal Business Name | NOVA NEPHROLOGY PSC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 615 TORRE MEDICA AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917-5029
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Country | US
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Telephone | 787-765-3300
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Fax | 787-765-3304
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Provider Business Mailing Address
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Address Line | 735 TORRE MEDICA AUXILIO MUTUO PONCE DE LEON SUITE 615
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City | SAN JUAN
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State | PR
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Zip | 00917-5029
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Country | US
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Telephone | 787-765-3300
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Fax | 787-765-3304
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANUEL FIGUEROA GONZALEZ
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Credential | M.D.
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Telephone | 787-765-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 16395
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License Number State | PR
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