Provider Demographics
NPI:1235718313
Name:UROVIDA LLC
Entity Type:Organization
Organization Name:UROVIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:X
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-432-5609
Mailing Address - Street 1:PO BOX 364641
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4641
Mailing Address - Country:US
Mailing Address - Phone:787-983-6768
Mailing Address - Fax:
Practice Address - Street 1:CALLE FERNANDEZ JUNCOS, ESQ MOLINILLO
Practice Address - Street 2:ANTIGUO EDIFICIO JESUS T. PINEIRO 80100
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-6179
Practice Address - Country:US
Practice Address - Phone:787-983-6768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty