Provider Demographics
NPI:1477821353
Name:PREMIER ANESTHESIA CONSULTANTS, P.S.C.
Entity Type:Organization
Organization Name:PREMIER ANESTHESIA CONSULTANTS, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:TRISTANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:787-398-7927
Mailing Address - Street 1:URB MONTEHIEDRA
Mailing Address - Street 2:#14 CALLE BIEN-TE-VEO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9533
Mailing Address - Country:US
Mailing Address - Phone:787-398-7927
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL SANTA ROSA
Practice Address - Street 2:8 AVE. LOS VETERANOS
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-864-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9361207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty