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Organization
AESTHETIC CENTER OF PUERTO RCO CSP
Active
Organization
AESTHETIC CENTER OF PUERTO RCO CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS IVAN MORELL (PRECIDENT)
(787) 850-8217
Entity
Organization
Contact information
Practice address
355 AVE FONT MARTELO, HOSPITAL RYDER OFICINA 402, HUMACAO, PR 00791-3249
(787) 850-8217
Mailing address
100 GRAND BLVD PASEO, SUITE 112 MSC 486, SAN JUAN, PR 00926
(787) 850-8217
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20484MO
—
PR
Enumeration date
12/28/2010
Last updated
12/28/2010
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