# UROLOGICAL PROFESSIONAL SERVICES PSC

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

## Provider details

- **NPI number:** 1265711667
- **Authorized official:** DR. RICHARD BAEZ TELLADO MD (PRESIDENT)
- **Authorized official phone:** (787) 432-7073

## Contact information

- **Practice address:** 2225 PONCE BY PASS, SUITE 504, PONCE, PR 00717-1321
- **Practice address phone:** (787) 432-7073
- **Practice address fax:** (787) 848-0318
- **Mailing address:** BOX 801453, COTO LAUREL, PR 00780-1453
- **Mailing address phone:** (787) 432-7073
- **Mailing address fax:** (787) 848-0318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 12897 | PR | Yes |

## Other

- **Enumeration date:** 08/16/2011
- **Last updated:** 08/16/2011