Organization
UROLOGICAL PROFESSIONAL SERVICES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BAEZ TELLADO MD (PRESIDENT)
(787) 432-7073
Entity
Organization
Contact information
Practice address
2225 PONCE BY PASS, SUITE 504, PONCE, PR 00717-1321
(787) 432-7073
(787) 848-0318
Mailing address
BOX 801453, COTO LAUREL, PR 00780-1453
(787) 432-7073
(787) 848-0318
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
12897
PR
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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