# SAN PABLO GASTROENTEROLOGY PSC

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

## Provider details

- **NPI number:** 1487035390
- **Authorized official:** DR. RICARDO JUAN MARRERO M.D. (OWNER)
- **Authorized official phone:** (787) 995-0500

## Contact information

- **Practice address:** 28 SANTA CRUZ STREET, TORRE SAN PABLO SUITE 202-A, BAYAMON, PR 00961
- **Practice address phone:** (787) 995-0500
- **Practice address fax:** (787) 785-0063
- **Mailing address:** 425 CARR 693, PMB 152, DORADO, PR 00646-4816
- **Mailing address phone:** (787) 995-0500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 16988 | PR | Yes |

## Other

- **Enumeration date:** 06/16/2015
- **Last updated:** 06/16/2015