Provider Demographics
NPI:1205163508
Name:XYRION MEDICAL INSTITUTE
Entity type:Organization
Organization Name:XYRION MEDICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICINA PRIMARIA,MEDICINA BARIATRI
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MPH
Authorized Official - Phone:787-210-1011
Mailing Address - Street 1:450 CALLE FERROCARRIL
Mailing Address - Street 2:SUITE 221
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-4107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 CALLE FERROCARRIL
Practice Address - Street 2:SUITE 221
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1105
Practice Address - Country:US
Practice Address - Phone:787-432-0208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty