Provider Demographics
NPI:1982830956
Name:ADVANCED RENAL CARE INSTITUTE
Entity Type:Organization
Organization Name:ADVANCED RENAL CARE INSTITUTE
Other - Org Name:INSTITUTO CUIDADO RENAL AVANZADO
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:O
Authorized Official - Last Name:HURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-677-7885
Mailing Address - Street 1:357 AVE HOSTOS STE 203
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-1535
Mailing Address - Country:US
Mailing Address - Phone:787-710-2532
Mailing Address - Fax:787-806-2239
Practice Address - Street 1:359 AVE HOSTOS STE 201
Practice Address - Street 2:OFFICE PARK IV
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1507
Practice Address - Country:US
Practice Address - Phone:939-475-3432
Practice Address - Fax:787-806-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16554261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16554OtherPUERTO RICO LICENCE