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General NPI Number Information
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NPI Number | 1760486575
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Entity Type | Organization
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Legal Business Name | ADVANCED PROFESSIONAL OB/GYN, PSC
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | EL MONTE MALL SHOPPING CENTER SUITE 3225 652 AVE MUNOZ-RIVERA
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-751-6210
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 493 PO BOX 70344
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City | SAN JUAN
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State | PR
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Zip | 00936-8344
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Country | US
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Telephone | 787-751-6210
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Fax |
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Authorized Official
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Title or Position | SR
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Name | ROBERTO F LOPEZ-ROSARIO
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Credential | M.D.
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Telephone | 787-751-6210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 13838
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 13460
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License Number State | PR
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