Provider Demographics
NPI:1639186810
Name:M&G ANESTHESIA SERVICES, PSC
Entity Type:Organization
Organization Name:M&G ANESTHESIA SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOLINARI CASTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-782-8389
Mailing Address - Street 1:PMB 342
Mailing Address - Street 2:35 JUAN C BORBON SUITE 67
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-782-8389
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:1785 CARR 21
Practice Address - Street 2:LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3399
Practice Address - Country:US
Practice Address - Phone:787-782-8389
Practice Address - Fax:787-848-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12807207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085016Medicare PIN