# DE DIEGO AMBULATORY CLINIC CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ASC San Juan Medical Plaza
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407813181
- **Authorized official:** DR. JORGE COLON M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (787) 977-7575

## Contact information

- **Practice address:** 150 AVE DE DIEGO, CONDOMINIO SAN JUAN HEALTH CENTRE BOX 1, SAN JUAN, PR 00907-2300
- **Practice address phone:** (787) 977-7575
- **Practice address fax:** (787) 977-7605
- **Mailing address:** 150 AVE DE DIEGO, CONDOMINIO SAN JUAN HEALTH CENTRE BOX 1, SAN JUAN, PR 00907-2300
- **Mailing address phone:** (787) 977-7575
- **Mailing address fax:** (787) 977-7605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 30 | PR | Yes |

## Other

- **Enumeration date:** 04/27/2006
- **Last updated:** 06/27/2022