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General NPI Number Information
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NPI Number | 1891125373
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Entity Type | Organization
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Legal Business Name | UROLOGY AMBULATORY SURGICAL CENTER
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | AVENIDA LAS AMERICAS HOSPITAL DR. PILA
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City | PONCE
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State | PR
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Zip | 00780
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Country | US
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Telephone | 787-848-6910
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Fax | 787-709-4730
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Provider Business Mailing Address
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Address Line | PO BOX 2908
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City | GUAYAMA
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State | PR
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Zip | 00785-2908
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Country | US
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Telephone | 787-866-3355
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Fax | 787-905-7288
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALBERTO CORICA GUINLE
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Credential | M.D.
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Telephone | 787-314-6821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 014585
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License Number State | PR
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