Provider Demographics
NPI:1689683526
Name:LLITERAS' PEDIATRIC GROUP, PSC
Entity Type:Organization
Organization Name:LLITERAS' PEDIATRIC GROUP, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LLITERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-375-9090
Mailing Address - Street 1:587 YUNES ST.
Mailing Address - Street 2:PALACIOS DEL RIO I
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-5022
Mailing Address - Country:US
Mailing Address - Phone:787-375-9090
Mailing Address - Fax:787-999-5559
Practice Address - Street 1:AVE PONCE DE LEON
Practice Address - Street 2:HOSPITAL AUXILIO MUTUO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1000
Practice Address - Country:US
Practice Address - Phone:787-375-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13897208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty