Provider Demographics
NPI:1972766210
Name:INSTITUTO GINECO-OBSTETRICO DE BARCELONETA
Entity Type:Organization
Organization Name:INSTITUTO GINECO-OBSTETRICO DE BARCELONETA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-623-8232
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0146
Mailing Address - Country:US
Mailing Address - Phone:787-623-8232
Mailing Address - Fax:787-623-3847
Practice Address - Street 1:1 CALLE TOMAS DAVILA
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2798
Practice Address - Country:US
Practice Address - Phone:787-623-8232
Practice Address - Fax:787-623-3847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15542207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty