Provider Demographics
NPI:1962113563
Name:UROISLA LLC
Entity type:Organization
Organization Name:UROISLA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREZ-ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-720-2150
Mailing Address - Street 1:PO BOX 4050
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-4050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAN JORGE MEDICAL OFFICE BUILDING
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-720-2150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty