Provider Demographics
NPI:1619421096
Name:ELITE OB-GYN
Entity Type:Organization
Organization Name:ELITE OB-GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-930-3410
Mailing Address - Street 1:C13 CALLE B
Mailing Address - Street 2:EL DORADO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3405
Mailing Address - Country:US
Mailing Address - Phone:787-237-8428
Mailing Address - Fax:787-946-7676
Practice Address - Street 1:1565 CALLE ALDA
Practice Address - Street 2:URB CARIBE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2712
Practice Address - Country:US
Practice Address - Phone:787-930-3410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18371261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty