Provider Demographics
NPI:1356640486
Name:MINIMALLY INVASIVE UROLOGY CENTER, PSC
Entity Type:Organization
Organization Name:MINIMALLY INVASIVE UROLOGY CENTER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON-HERDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-250-8985
Mailing Address - Street 1:#576 CESAR GONZALEZ STREET
Mailing Address - Street 2:ADLER MEDICAL PLAZA, SUITE 304
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-250-8985
Mailing Address - Fax:787-764-6439
Practice Address - Street 1:ADLER MEDICAL PLAZA, SUITE 304
Practice Address - Street 2:576 CESAR GONZALEZ AVENUE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-250-8985
Practice Address - Fax:787-764-6439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15396208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty