Organization
PROFESSIONAL ADVANCE LAPAROSCOPY & SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN C LOPEZ DE VICTORIA RIVERA (PRESIDENT)
(787) 372-4022
Entity
Organization
Contact information
Practice address
AVE A1 402, LUIS MUNOOS MARIN, CAGUAS, PR 00725-0000
(787) 272-4022
Mailing address
PO BOX 4960, PMB 381, CAGUAS, PR 00726-4960
(787) 372-4022
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
016783
PR
261Q00000X
Clinic/Center
MD429473
PA
Other
Enumeration date
05/06/2010
Last updated
11/02/2010
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