Provider Demographics
NPI:1063621241
Name:ASOCIADOS EN NEFROLOGIA CSP
Entity type:Organization
Organization Name:ASOCIADOS EN NEFROLOGIA CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRILLASCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-259-1934
Mailing Address - Street 1:PO BOX 800291
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0291
Mailing Address - Country:US
Mailing Address - Phone:787-259-1934
Mailing Address - Fax:787-840-7734
Practice Address - Street 1:TORRE SAN CRISTOBAL
Practice Address - Street 2:SUITE 302
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-259-1934
Practice Address - Fax:787-840-7734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10497207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty