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Organization

LCS SURGICAL SERVICES PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LUIS DANIEL CARCORZE SOTO M.D. (SOLE OWNER)
(787) 951-7074
Entity
Organization

Contact information

Practice address
15 CALLE DR BASORA N, MAYAGUEZ, PR 00680-4833
(787) 834-0101
Mailing address
PO BOX 819, MAYAGUEZ, PR 00681-0819
(787) 951-7074

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18625
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1689807968
NPI PERSONAL
PR
01
18625
LICENCIA MEDICO PUERTO RICO
PR
Enumeration date
05/19/2014
Last updated
07/17/2014
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