Provider Demographics
NPI:1689940496
Name:ORTHOPAEDIC HAND AND UPPER EXTREMITY PSC
Entity Type:Organization
Organization Name:ORTHOPAEDIC HAND AND UPPER EXTREMITY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC HAND SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RODRIGUEZ ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-415-0081
Mailing Address - Street 1:F15 CALLE SAN GABRIEL
Mailing Address - Street 2:SAN PEDRO ESTATES
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-7642
Mailing Address - Country:US
Mailing Address - Phone:787-415-0081
Mailing Address - Fax:
Practice Address - Street 1:COND PLAZA DE DIEGO
Practice Address - Street 2:310 AVE DE DIEGO SUITE 301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1730
Practice Address - Country:US
Practice Address - Phone:787-721-5505
Practice Address - Fax:781-721-5388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18200207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty