Organization
AVANTSURGICAL PR PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO LUIS CHINEA M.D. (PRESIDENT)
(787) 242-2085
Entity
Organization
Contact information
Practice address
29 WASHINGTON STREET, ASHFORD MEDICAL CENTER SUITE 505, SAN JUAN, PR 00907
(787) 721-2243
(787) 721-2204
Mailing address
G-9 AVE SAN PATRICIO, APT 101, GUAYNABO, PR 00968
(787) 242-2085
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17884
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447455522
INDIVIDUAL PROVIDER NPI
PR
01
—
17884
STATE LICENSE
PR
Enumeration date
03/15/2015
Last updated
07/16/2015
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