Basic Information
| Provider Information | |||||||||
| NPI: | 1831165265 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GASTROENTEROLOGY AND THERAPEUTIC ENDOSCOPY CENTER PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29 CALLE WASHINGTON | ||||||||
| Address2: | ASHFORD MEDICAL CENTER SUITE 202 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009071510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879775012 | ||||||||
| FaxNumber: | 7879775062 | ||||||||
| Practice Location | |||||||||
| Address1: | 29 CALLE WASHINGTON | ||||||||
| Address2: | ASHFORD MEDICAL CENTER SUITE 202 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009071510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879775012 | ||||||||
| FaxNumber: | 7879775062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2006 | ||||||||
| LastUpdateDate: | 11/20/2013 | ||||||||
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| AuthorizedOfficialLastName: | PEREZ ARROYO | ||||||||
| AuthorizedOfficialFirstName: | HECTOR | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7879775012 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 12535 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.