Provider Demographics
NPI:1588088652
Name:INSTITUTO DE CIRUGIA PLASTICA METROPOLITANO
Entity type:Organization
Organization Name:INSTITUTO DE CIRUGIA PLASTICA METROPOLITANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORO-PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-722-0022
Mailing Address - Street 1:1509 AVE PONCE DE LEON
Mailing Address - Street 2:CIUDADELA, SUITE 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1728
Mailing Address - Country:US
Mailing Address - Phone:787-722-0022
Mailing Address - Fax:787-723-2853
Practice Address - Street 1:1509 AVE PONCE DE LEON
Practice Address - Street 2:CIUDADELA, SUITE 1
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1728
Practice Address - Country:US
Practice Address - Phone:787-722-0022
Practice Address - Fax:787-723-2853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13466208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609896927OtherNPI