Provider Demographics
NPI:1598191793
Name:YSL PSC
Entity Type:Organization
Organization Name:YSL PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENDEZ MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-777-8181
Mailing Address - Street 1:30 CALLE TURQUESA
Mailing Address - Street 2:SENDEROS EN MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7064
Mailing Address - Country:US
Mailing Address - Phone:787-636-8272
Mailing Address - Fax:
Practice Address - Street 1:AVE PONCE DE LEON PARADA 37 1/2
Practice Address - Street 2:SUITE 608 TORRE DE AUXILIO MUTUO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-777-8181
Practice Address - Fax:787-777-8180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12903207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21542OtherMEDICARE
21542OtherSSS
21542OtherSSS