Provider Demographics
NPI:1871631093
Name:ADVANCE ANESTHESIA SERVICE
Entity Type:Organization
Organization Name:ADVANCE ANESTHESIA SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-818-6010
Mailing Address - Street 1:PO BOX 6409
Mailing Address - Street 2:MARINA STATION
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6409
Mailing Address - Country:US
Mailing Address - Phone:787-818-6010
Mailing Address - Fax:
Practice Address - Street 1:550 CONCEPCION VERA AYALA
Practice Address - Street 2:CARRETERA 110 KM 12.2
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-6010
Practice Address - Fax:787-818-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty