Provider Demographics
NPI:1427698208
Name:PUERTO RICO ADVANCED UROLOGY CENTER, LLC
Entity type:Organization
Organization Name:PUERTO RICO ADVANCED UROLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:DUBOCQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-948-3431
Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1847
Mailing Address - Country:US
Mailing Address - Phone:787-786-5305
Mailing Address - Fax:787-740-2140
Practice Address - Street 1:100 AVE LAUREL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4816
Practice Address - Country:US
Practice Address - Phone:787-786-5307
Practice Address - Fax:787-740-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QL0400XAmbulatory Health Care FacilitiesClinic/CenterLithotripsy
No282N00000XHospitalsGeneral Acute Care Hospital