Provider Demographics
NPI:1265633879
Name:BIOGYN OBSTETRICS CSP
Entity Type:Organization
Organization Name:BIOGYN OBSTETRICS CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-740-5602
Mailing Address - Street 1:SANTA CRUZ #66 ,INSTITUTO SAN PABLO
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-740-5602
Mailing Address - Fax:787-798-1446
Practice Address - Street 1:66 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 310, INSTITUTO SAN PABLO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7041
Practice Address - Country:US
Practice Address - Phone:787-740-5602
Practice Address - Fax:787-798-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5698174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD99625Medicare UPIN
PR20386Medicare ID - Type Unspecified