Provider Demographics
NPI:1568853687
Name:INSTITUTO DE GINECOLOGIA Y OBSTETRICIA DEL SUR
Entity type:Organization
Organization Name:INSTITUTO DE GINECOLOGIA Y OBSTETRICIA DEL SUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:L
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-841-2314
Mailing Address - Street 1:PO BOX 7245
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7245
Mailing Address - Country:US
Mailing Address - Phone:787-841-2314
Mailing Address - Fax:
Practice Address - Street 1:628 CALLE PEDRO VELAZQUEZ A 2 A 3
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624
Practice Address - Country:US
Practice Address - Phone:787-836-2214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Multi-Specialty