Provider Demographics
NPI:1215145867
Name:SERVICIO DEANESTESIA Y MANEJO DEL DOLOR SAN ANTONIO
Entity type:Organization
Organization Name:SERVICIO DEANESTESIA Y MANEJO DEL DOLOR SAN ANTONIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:I
Authorized Official - Last Name:LABOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-0050
Mailing Address - Street 1:18N POST STREET
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-834-0050
Mailing Address - Fax:787-832-8685
Practice Address - Street 1:18N POST STREET
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-834-0050
Practice Address - Fax:787-832-8685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7450174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty