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General NPI Number Information
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NPI Number | 1902212905
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Entity Type | Organization
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Legal Business Name | ADVANCE UROLOGY & LAPAROSCOPIC CTR PSC
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 909 AVE TITO CASTRO STE 710 TORRE MEDICA SAN LUCAS
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-284-3333
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Fax | 787-284-1722
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Provider Business Mailing Address
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Address Line | 609 AVE TITO CASTRO STE 102 PMB 363
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City | PONCE
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State | PR
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Zip | 00716-0200
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Country | US
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Telephone | 787-284-3333
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Fax | 787-284-1722
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GILBERTO RUIZ DEYA
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Credential | MD
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Telephone | 787-284-3333
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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 | 13510
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License Number State | PR
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