Provider Demographics
NPI:1821021213
Name:EQUIPO GINECOLOGICO Y OBSTETRICO DE SALUD,P.S.C.
Entity Type:Organization
Organization Name:EQUIPO GINECOLOGICO Y OBSTETRICO DE SALUD,P.S.C.
Other - Org Name:E.G.O.S., P.S.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAVAS MICHEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACOG
Authorized Official - Phone:787-744-5414
Mailing Address - Street 1:158 CALLE FONT MARTELO
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3337
Mailing Address - Country:US
Mailing Address - Phone:787-852-3560
Mailing Address - Fax:787-852-3538
Practice Address - Street 1:66 AVE DEGETAU APT 500
Practice Address - Street 2:HIMA PLAZA I SUITE 505
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5844
Practice Address - Country:US
Practice Address - Phone:787-744-5414
Practice Address - Fax:787-258-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR67906OtherLA CRUZ AZUL DE PUERTO RI
PR89732OtherTRIPLE S
PRPE1198OtherPAN AMERICAN LIFE INS
PR2501OtherINTERNATIONAL MEDICAL CAR
PR6610095OtherHUMANA
PRPE1198OtherPAN AMERICAN LIFE INS
PR67906OtherLA CRUZ AZUL DE PUERTO RI