MEDICARE: ORTHOPAEDIC HAND AND UPPER EXTREMITY PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0106X	Orthopaedic Hand Surgery Physician	18200	PR

General Provider Information

NPI Number	:	1689940496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPAEDIC HAND AND UPPER EXTREMITY PSC

Provider Business Mailing Address
First Line	:	F15 CALLE SAN GABRIEL
Second Line	:	SAN PEDRO ESTATES
City	:	CAGUAS
State	:	PR
Zip	:	00725-7642
Country	:	US
Telephone Number	:	787-415-0081
Fax Number	:

Provider Business Practice Location Address
First Line	:	COND PLAZA DE DIEGO
Second Line	:	310 AVE DE DIEGO SUITE 301
City	:	SAN JUAN
State	:	PR
Zip	:	00909-1730
Country	:	US
Telephone Number	:	787-721-5505
Fax Number	:	781-721-5388

Authorized Official
Title or Position	:	ORTHOPAEDIC HAND SURGEON
Name	:	DR. YESENIA MARIA RODRIGUEZ ALVAREZ
Credential	:	MD
Telephone Number	:	787-415-0081

Provider Enumeration Date	:	03/26/2012
Last Update Date	:	07/19/2012

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