Provider Demographics
NPI:1336545250
Name:METRO BAY SURGICAL GROUP CSP
Entity Type:Organization
Organization Name:METRO BAY SURGICAL GROUP CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRELLASRUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-787-3535
Mailing Address - Street 1:BAYAMON MEDICAL MALL
Mailing Address - Street 2:1845 CARR #2 OFICINA 307
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7200
Mailing Address - Country:US
Mailing Address - Phone:787-787-3535
Mailing Address - Fax:787-787-3550
Practice Address - Street 1:BAYAMON MEDICAL MALL
Practice Address - Street 2:1845 CARR #2 OFICINA 307
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-787-3535
Practice Address - Fax:787-787-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13412208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty