Provider Demographics
NPI:1720115249
Name:GASTROCORP & ASSOC., PSC
Entity Type:Organization
Organization Name:GASTROCORP & ASSOC., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDCO
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUIZ FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-258-3245
Mailing Address - Street 1:PO BOX 8008
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8008
Mailing Address - Country:US
Mailing Address - Phone:787-258-3245
Mailing Address - Fax:787-744-1120
Practice Address - Street 1:A7 AVE DEGETAU
Practice Address - Street 2:URB BONNEVILLE TERRACE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-258-3245
Practice Address - Fax:787-761-5764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11831207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0088004Medicare PIN
PRE21543Medicare UPIN
PR88004Medicare PIN