Provider Demographics
NPI:1023547643
Name:ARIST MEDICAL SCIENCES UNIVERSITY, PBC
Entity Type:Organization
Organization Name:ARIST MEDICAL SCIENCES UNIVERSITY, PBC
Other - Org Name:PHSU WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEAN FOR CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTAING LESPIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-840-0052
Mailing Address - Street 1:PO BOX 7004
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7004
Mailing Address - Country:US
Mailing Address - Phone:787-840-0052
Mailing Address - Fax:787-840-2317
Practice Address - Street 1:396 CALLE DR LUIS F SALA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-840-0052
Practice Address - Fax:787-840-2317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIST MEDICAL SCIENCES UNIVERSITY, PBC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRIF404AMedicaid