# ADVANCED UROLOGY GROUP INC

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

## Provider details

- **NPI number:** 1396164067
- **Authorized official:** DR. JAVIER ENRIQUE COLON-IRIZARRY M.D. (PRESIDENT)
- **Authorized official phone:** (787) 652-1755

## Contact information

- **Practice address:** 410 AVE HOSTOS, PRIMER PISO OFICINA 111N, MAYAGUEZ, PR 00682-1560
- **Practice address phone:** (787) 652-1755
- **Mailing address:** PO BOX 3168, MAYAGUEZ, PR 00681-3168
- **Mailing address phone:** (787) 652-1755
- **Mailing address fax:** (787) 652-1760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 18043 | PR | Yes |

## Other

- **Enumeration date:** 04/10/2014
- **Last updated:** 04/10/2014