Provider Demographics
NPI:1629641469
Name:GR SURGERY LLC
Entity Type:Organization
Organization Name:GR SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-630-2367
Mailing Address - Street 1:210 CALLE JOSE OLIVER
Mailing Address - Street 2:NEW CENTER PLAZA #1405
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-615-6963
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 172 DE CAGUAS A CIDRA, URB TURABO GARDENS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-630-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty