Provider Demographics
NPI:1447576590
Name:URO CLINIC CSP
Entity Type:Organization
Organization Name:URO CLINIC CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FEDERICO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:CORICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-918-1744
Mailing Address - Street 1:PO BOX 2908
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2908
Mailing Address - Country:US
Mailing Address - Phone:787-918-1744
Mailing Address - Fax:787-864-6488
Practice Address - Street 1:HWY 3
Practice Address - Street 2:HOSPITAL LAFAYETTE 1ST FLOOR
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714
Practice Address - Country:US
Practice Address - Phone:787-918-1744
Practice Address - Fax:787-864-6488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5528174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty