Basic Information
| Provider Information | |||||||||
| NPI: | 1386726842 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOMOHANO OB GYN SERVICES, PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 193467 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009193467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877560100 | ||||||||
| FaxNumber: | 7877560103 | ||||||||
| Practice Location | |||||||||
| Address1: | 652 AVE MUNOZ RIVERA | ||||||||
| Address2: | MONTE MALL SUITE 2065 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009184257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877560100 | ||||||||
| FaxNumber: | 7877560103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 06/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | SOMOHANO | ||||||||
| AuthorizedOfficialFirstName: | JOSE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENTE | ||||||||
| AuthorizedOfficialTelephone: | 7877560100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 12040 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.