Provider Demographics
NPI:1386726842
Name:SOMOHANO OB GYN SERVICES, PSC
Entity type:Organization
Organization Name:SOMOHANO OB GYN SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMOHANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-756-0100
Mailing Address - Street 1:PO BOX 193467
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3467
Mailing Address - Country:US
Mailing Address - Phone:787-756-0100
Mailing Address - Fax:787-756-0103
Practice Address - Street 1:652 AVE MUNOZ RIVERA
Practice Address - Street 2:MONTE MALL SUITE 2065
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4257
Practice Address - Country:US
Practice Address - Phone:787-756-0100
Practice Address - Fax:787-756-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12040207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherEIN