Provider Demographics
NPI:1467818088
Name:VRT OB GYN GROUP PSC
Entity Type:Organization
Organization Name:VRT OB GYN GROUP PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAMOS TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-217-4814
Mailing Address - Street 1:204 PERLA DEL CARIBE C27
Mailing Address - Street 2:MANSIONES DE MONTE VERDE
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736
Mailing Address - Country:US
Mailing Address - Phone:787-217-4814
Mailing Address - Fax:787-946-7326
Practice Address - Street 1:CALLE STANLEY MILLER
Practice Address - Street 2:BO CAONILLAS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-217-4814
Practice Address - Fax:787-946-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17210207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0028702Medicare PIN