# ADVANCED ANTI AGING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093226995
- **Authorized official:** DR. JOSE L LIZARDI (DOCTOR)
- **Authorized official phone:** (315) 244-1396

## Contact information

- **Practice address:** 29 WASHINGTON STREET ASHFORD MEDICAL CENTER, SUITE 310, SAN JUAN, PR 00907
- **Practice address phone:** (787) 400-9779
- **Mailing address:** 3307 ISLA VERDE AVE., SURFSIDE MANSIONS, APT 1105, CAROLINA, PR 00979
- **Mailing address phone:** (315) 244-1396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | PR | Yes |

## Other

- **Enumeration date:** 10/18/2017
- **Last updated:** 10/18/2017