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General NPI Number Information
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NPI Number | 1437488863
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Entity Type | Organization
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Legal Business Name | AV ANESTHESIOLOGY GROUP PSC
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Dates
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Enumeration Date | 12/14/2009
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 550 CALLE SERGIO CUEVAS
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City | SAN JUAN
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State | PR
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Zip | 00918-2683
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Country | US
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Telephone | 787-407-1615
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Fax | 787-759-0101
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Provider Business Mailing Address
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Address Line | URB CROWN HILLS 138 AVE WINSTON CHURCHILL PMB 854
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City | SAN JUAN
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State | PR
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Zip | 00926-0613
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Country | US
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Telephone | 787-758-8383
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Fax | 787-759-0101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYMARI VARGAS RIVERA
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Credential | MD
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Telephone | 787-407-1615
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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 | 15740
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License Number State | PR
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