Provider Demographics
NPI:1285777326
Name:APCG UROLOGY C S P
Entity type:Organization
Organization Name:APCG UROLOGY C S P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CORICA GUINLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-866-3355
Mailing Address - Street 1:P.O.BOX 2908
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-864-4300
Mailing Address - Fax:787-864-6488
Practice Address - Street 1:HOSPITAL EPISCOPAL CRISTO REDENTOR
Practice Address - Street 2:AVE. PEDRO ALBIZU CAMPOS URB. LA HACIENDA
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:787-864-6488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14585302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2721OtherPREFERRED CHOICE
PR9824OtherINTERNATIONAL MEDICAL CAR
PR7850017OtherHUMANA INSURANCE
PR207045OtherUTI PROVDIERNUMBER
PR21089OtherSSS PROVIDER NUMBER
PR9824OtherINTERNATIONAL MEDICAL CAR
PR0021089Medicare ID - Type UnspecifiedPROVIDER NUMBER MEDICARE