Organization
ADVANCED ANTI AGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE L LIZARDI (DOCTOR)
(315) 244-1396
Entity
Organization
Contact information
Practice address
29 WASHINGTON STREET ASHFORD MEDICAL CENTER, SUITE 310, SAN JUAN, PR 00907
(787) 400-9779
Mailing address
3307 ISLA VERDE AVE., SURFSIDE MANSIONS, APT 1105, CAROLINA, PR 00979
(315) 244-1396
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
PR
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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