Provider Demographics
NPI:1922313923
Name:ORTOPEDAS ASOCIADOS DEL OESTE PSC
Entity Type:Organization
Organization Name:ORTOPEDAS ASOCIADOS DEL OESTE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTALATIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-833-6893
Mailing Address - Street 1:PO BOX 990
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0990
Mailing Address - Country:US
Mailing Address - Phone:787-833-6893
Mailing Address - Fax:787-831-1011
Practice Address - Street 1:1065 AVE LOS CORAZONES
Practice Address - Street 2:SUITE 102
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-7060
Practice Address - Country:US
Practice Address - Phone:787-833-6893
Practice Address - Fax:787-831-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty