Provider Demographics
NPI:1225121999
Name:INSTITUTO ORTOPEDICO CAGUAS
Entity Type:Organization
Organization Name:INSTITUTO ORTOPEDICO CAGUAS
Other - Org Name:INSTITUTO ORTOPEDICO CAGUAS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENTTE
Authorized Official - Prefix:
Authorized Official - First Name:BENIGNO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-744-4654
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-744-4654
Mailing Address - Fax:787-743-4959
Practice Address - Street 1:EDIF. HIMA SAN PABLO CIRUGIA AMBULATORIA
Practice Address - Street 2:CALLE MUNOZ RIVERA NUM. 1 FIINAL OFIC. 203
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-744-4654
Practice Address - Fax:787-743-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-4588-1OtherCIGNA
PR3-4588-1OtherCIGNA
PR72550075OtherHUMANA
PR72550075OtherHUMANA
PRC77426Medicare UPIN