# SERVICIOS UROLOGICOS DE PUERTO RICO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SERVICIOS UROLOGICOS DE PUERTO RICO
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659702199
- **Legal business name:** SERVICIOS UROLOGICOS DE PUERTO RICO
- **Authorized official:** DR. GIL NIEVES LATIMER (PRESIDENT)
- **Authorized official phone:** (787) 753-8514

## Contact information

- **Practice address:** 735 AVE PONCE DE LEON, TORRE MEDICA AUXILIO MUTUO SUITE 409, SAN JUAN, PR 00917-5022
- **Practice address phone:** (787) 753-8514
- **Practice address fax:** (787) 753-2883
- **Mailing address:** 35 CALLE JUAN C BORBON, SUITE 67-195, GUAYNABO, PR 00969-5374
- **Mailing address phone:** (787) 753-8514
- **Mailing address fax:** (787) 753-2883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | PR | Yes |
| 302F00000X | Exclusive Provider Organization | 599143713 | PR | — |
| 302R00000X | Health Maintenance Organization | — | PR | — |
| 305R00000X | Preferred Provider Organization | — | NULL | — |
| 305R00000X | Preferred Provider Organization | — | PR | — |
| 305S00000X | Point of Service | — | PR | — |

## Other

- **Enumeration date:** 12/10/2013
- **Last updated:** 07/21/2022