Provider Demographics
NPI:1770444630
Name:PVC MEDICAL GI LLC
Entity type:Organization
Organization Name:PVC MEDICAL GI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PALOMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VELASCO CORRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-638-2248
Mailing Address - Street 1:576 AVE ARTERIAL B APT 803
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2223
Mailing Address - Country:US
Mailing Address - Phone:787-638-2248
Mailing Address - Fax:
Practice Address - Street 1:576 AVE ARTERIAL B APT 803
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2223
Practice Address - Country:US
Practice Address - Phone:787-638-2248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty