Provider Demographics
NPI:1649577263
Name:PARIO-OBGYN, PSC
Entity Type:Organization
Organization Name:PARIO-OBGYN, 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:E
Authorized Official - Last Name:PARDO-TORO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-374-8951
Mailing Address - Street 1:TORRE MEDICA SAN PABLO AV. GENERAL VALERO 410
Mailing Address - Street 2:SUITE 207
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:UM
Mailing Address - Phone:787-374-8951
Mailing Address - Fax:787-961-4569
Practice Address - Street 1:TORRE MEDICA SAN PABLO AV. GENERAL VALERO 410
Practice Address - Street 2:SUITE 207
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:UM
Practice Address - Phone:787-374-8951
Practice Address - Fax:787-961-4569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13961261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1700834439Medicare UPIN