Provider Demographics
NPI:1780660738
Name:INSTITUTO URO-GINECOLOGICO OBSTETRICO DEL SUR, P.S.C.
Entity Type:Organization
Organization Name:INSTITUTO URO-GINECOLOGICO OBSTETRICO DEL SUR, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCUAL-VILLARONGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-429-9120
Mailing Address - Street 1:MAYAGUEZ MEDICAL CENTER OFFICE I-119
Mailing Address - Street 2:P.O. BOX 600
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681
Mailing Address - Country:US
Mailing Address - Phone:787-652-9200
Mailing Address - Fax:787-805-5188
Practice Address - Street 1:410 AVE HOSTOS KM 1.57 SABALOS
Practice Address - Street 2:MAYAGUEZ MEDICAL CENTER OFIC I-119
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-805-5188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10894207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG21744Medicare UPIN