Provider Demographics
NPI:1477960334
Name:UROSALUD, P.S.C.
Entity type:Organization
Organization Name:UROSALUD, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-259-7293
Mailing Address - Street 1:909 AVE TITO CASTRO
Mailing Address - Street 2:TORRE MEDICA SAN LUCAS SUITE #510
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-4728
Mailing Address - Country:US
Mailing Address - Phone:787-259-7293
Mailing Address - Fax:787-840-6679
Practice Address - Street 1:909 AVE TITO CASTRO
Practice Address - Street 2:TORRE MEDICA SAN LUCAS SUITE #510
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4728
Practice Address - Country:US
Practice Address - Phone:787-259-7293
Practice Address - Fax:787-840-6679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18175208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty