Provider Demographics
NPI:1326478140
Name:AMBULATORY UROLOGY SURGICAL CENTER
Entity Type:Organization
Organization Name:AMBULATORY UROLOGY SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:P
Authorized Official - Last Name:CORICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-866-3355
Mailing Address - Street 1:2435 BLVD LUIS A FERRE
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2112
Mailing Address - Country:US
Mailing Address - Phone:787-866-3355
Mailing Address - Fax:787-709-4730
Practice Address - Street 1:2435 BLVD LUIS A FERRE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2112
Practice Address - Country:US
Practice Address - Phone:787-866-3355
Practice Address - Fax:787-709-4730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty