Provider Demographics
NPI:1679828404
Name:LIN, P.S.C
Entity Type:Organization
Organization Name:LIN, P.S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:GORDO GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-478-8040
Mailing Address - Street 1:COND FRANCISCO JAVIER 406
Mailing Address - Street 2:CALLE SAN JOSE 50
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-478-8040
Mailing Address - Fax:787-281-0036
Practice Address - Street 1:CONDOMINIO FRANCISCO JAVIER 406
Practice Address - Street 2:CALLE SAN JOSE 50
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-478-8040
Practice Address - Fax:787-281-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9049207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty