Provider Demographics
NPI:1831492214
Name:INSTITUTO UROLOGICO DEL CARIBE PSC
Entity type:Organization
Organization Name:INSTITUTO UROLOGICO DEL CARIBE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-840-6339
Mailing Address - Street 1:PO BOX 801043
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1043
Mailing Address - Country:US
Mailing Address - Phone:787-840-6339
Mailing Address - Fax:787-840-1803
Practice Address - Street 1:TORRE SAN CRISTOBAL
Practice Address - Street 2:SUITE 301
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2849
Practice Address - Country:US
Practice Address - Phone:787-840-6339
Practice Address - Fax:787-840-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7079208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0026907Medicare PIN