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General NPI Number Information
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NPI Number | 1871609610
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Entity Type | Organization
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Legal Business Name | ENDOUROLOGICAL INSTITUTE INC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | ENDOUROLOGICAL INSTITUTE INC-CENTRO CIRUGIA AMBULATORIA 735 AVE PONCE DE LEON SUITE 608-612 TORRE AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917-5028
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Country | US
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Telephone | 787-777-8181
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Fax | 787-777-8180
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Provider Business Mailing Address
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Address Line | 755 AVENIDA PONCE DE LEON TORRE DE AUXILIO MUTUO SUITE 608
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City | SAN JUAN
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State | PR
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Zip | 00917-5028
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Country | US
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Telephone | 787-777-8181
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Fax | 787-777-8180
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Authorized Official
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Title or Position | PRESIDENT ENDOUROLOGICAL INSTITUTE
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Name | PABLO E CARDONA DOBLE
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Credential | MD
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Telephone | 787-777-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 14
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License Number State | PR
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