Provider Demographics
NPI:1598978835
Name:GRUPO RENAL DEL ESTE PSC.
Entity Type:Organization
Organization Name:GRUPO RENAL DEL ESTE PSC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:AYALA-SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:787-746-7441
Mailing Address - Street 1:P.O. BOX 6628
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6628
Mailing Address - Country:US
Mailing Address - Phone:787-746-7441
Mailing Address - Fax:787-746-3190
Practice Address - Street 1:201 CALLE GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MEDICAL PLAZA SUITE 307
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-746-7441
Practice Address - Fax:787-746-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty