Provider Demographics
NPI:1235352626
Name:OUTPATIENT SURGERY
Entity Type:Organization
Organization Name:OUTPATIENT SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:ESQUIRE
Authorized Official - Phone:787-764-5655
Mailing Address - Street 1:PO BOX 1900
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1900
Mailing Address - Country:US
Mailing Address - Phone:787-764-5655
Mailing Address - Fax:
Practice Address - Street 1:MUNOZ RIVERA AVE.
Practice Address - Street 2:1-A
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-764-5655
Practice Address - Fax:787-764-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR108261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083855Medicare ID - Type Unspecified