Provider Demographics
NPI:1922211044
Name:DC ANESTHESIA PSC
Entity Type:Organization
Organization Name:DC ANESTHESIA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PORRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-621-0590
Mailing Address - Street 1:PO BOX 1062
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1062
Mailing Address - Country:US
Mailing Address - Phone:787-621-0590
Mailing Address - Fax:787-621-0593
Practice Address - Street 1:CARRETERA #2 KM 47.7
Practice Address - Street 2:DOCTOR'S CENTER HOSPITAL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-0590
Practice Address - Fax:787-621-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR305R00000X305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization