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General NPI Number Information
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NPI Number | 1376850677
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Entity Type | Organization
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Legal Business Name | UROLOGY CARE LLC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 369 DE DIEGO TORRE SAN FRANCISCO SUITE 207
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City | SAN JUAN
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State | PR
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Zip | 00923-0025
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Country | US
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Telephone | 787-767-7614
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 747 1353 RD 19
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City | GUAYNABO
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State | PR
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Zip | 00966-0000
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Country | US
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Telephone | 787-767-7614
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NORMAN J DE LA ROSA
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Credential | M.D.
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Telephone | 787-767-7614
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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 | 15439
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License Number State | PR
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