Provider Demographics
NPI:1366854689
Name:NORTH SURGICAL SERVICES CORP,PSC
Entity Type:Organization
Organization Name:NORTH SURGICAL SERVICES CORP,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVIERE WILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-884-8337
Mailing Address - Street 1:TORRE MEDICA DR PEDRO BLANCO LUGO
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-884-8337
Mailing Address - Fax:787-854-3287
Practice Address - Street 1:TORRE MEDICA DR PEDRO BLANCO LUGO
Practice Address - Street 2:SUITE 205
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-8337
Practice Address - Fax:787-854-3287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14757174400000X
PR14781174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1427198746OtherNATIONAL PROVIDER IDENTIFICATION
PR1427198746OtherNATIONAL PROVIDER IDENTIFICATION