# PROFESSIONAL ADVANCE LAPAROSCOPY & SURGERY

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

## Provider details

- **NPI number:** 1932427630
- **Authorized official:** DR. JUAN C LOPEZ DE VICTORIA RIVERA (PRESIDENT)
- **Authorized official phone:** (787) 372-4022

## Contact information

- **Practice address:** AVE A1 402, LUIS MUNOOS MARIN, CAGUAS, PR 00725-0000
- **Practice address phone:** (787) 272-4022
- **Mailing address:** PO BOX 4960, PMB 381, CAGUAS, PR 00726-4960
- **Mailing address phone:** (787) 372-4022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 016783 | PR | Yes |
| 261Q00000X | Clinic/Center | MD429473 | PA | — |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 11/02/2010