Provider Demographics
NPI:1508047069
Name:INSTITUTO UROLOGIA INTEGRADA
Entity Type:Organization
Organization Name:INSTITUTO UROLOGIA INTEGRADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ-BLAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-833-0743
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0966
Mailing Address - Country:US
Mailing Address - Phone:787-833-0473
Mailing Address - Fax:787-832-3088
Practice Address - Street 1:14-E CALLE DE DIEGO
Practice Address - Street 2:EDIFICIO MEDICO DE DIEGO 101
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-833-0473
Practice Address - Fax:787-832-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9460208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty