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General NPI Number Information
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NPI Number | 1518453299
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Entity Type | Organization
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Legal Business Name | YLC MIGS-CPP SPECIALIST LLC
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 07/06/2018
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 812
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City | SAN JUAN
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State | PR
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Zip | 00917-5031
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Country | US
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Telephone | 787-758-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 15 CALLE LUNA URB ADOQUINES
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-293-5386
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOLIANNE LOZADA
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Credential | MD
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Telephone | 787-307-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State | PR
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