Provider Demographics
NPI:1598841538
Name:NORTH OB-GYN SERVICES, PSC
Entity Type:Organization
Organization Name:NORTH OB-GYN SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OTERO-QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-0800
Mailing Address - Street 1:ESTANCIAS DE TORTUGUERO
Mailing Address - Street 2:629 TURIN ST.
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-854-0800
Mailing Address - Fax:787-854-0808
Practice Address - Street 1:EDIFICIO MEDICO I DR. PEDRO BLANCO LUGO
Practice Address - Street 2:CARR. 2 KM. 47.7 SUITE 305
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4665
Practice Address - Country:US
Practice Address - Phone:787-854-0800
Practice Address - Fax:787-854-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10724207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6740082OtherHUMANA
PR06503OtherLA CRUZ AZUL
PR89144OtherTRIPLE S
PR=========OtherINTERNATIONAL MEDICAL CAR
PRH27303Medicare UPIN
PR=========OtherINTERNATIONAL MEDICAL CAR