Provider Demographics
NPI:1619324266
Name:CENTRO DE UROLOGIA LA MONTANA C.S.P.
Entity Type:Organization
Organization Name:CENTRO DE UROLOGIA LA MONTANA C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:YULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-744-0670
Mailing Address - Street 1:PO BOX 371355
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-1355
Mailing Address - Country:US
Mailing Address - Phone:787-744-0670
Mailing Address - Fax:
Practice Address - Street 1:1 AVE 500 DEGETAU HIMA PLAZA
Practice Address - Street 2:SUITE 413
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7307
Practice Address - Country:US
Practice Address - Phone:787-744-0670
Practice Address - Fax:787-961-4682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4802208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty