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General NPI Number Information
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NPI Number | 1831492214
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Entity Type | Organization
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Legal Business Name | INSTITUTO UROLOGICO DEL CARIBE PSC
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | TORRE SAN CRISTOBAL SUITE 301
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City | COTO LAUREL
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State | PR
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Zip | 00780-2849
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Country | US
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Telephone | 787-840-6339
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Fax | 787-840-1803
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Provider Business Mailing Address
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Address Line | PO BOX 801043
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City | COTO LAUREL
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State | PR
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Zip | 00780-1043
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Country | US
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Telephone | 787-840-6339
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Fax | 787-840-1803
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HECTOR M CORDERO
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Credential | MD
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Telephone | 787-840-6339
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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 | 7079
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License Number State | PR
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