Colon and Rectal Surgical Group of Puerto Rico PSC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

10722 Issued in PR

Legal business name

COLON AND RECTAL SURGICAL GROUP OF PUERTO RICO PSC

Practice address

107 Gonzalez Guisti Ave
Caparra Gallery BLDG Suite 305
Guaynabo, PR 00966-3017

Phone

(787) 707-0095

Fax

(787) 707-0096

NPI assigned

Nov 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Santiago Antonio Ulloa

Title

President

Phone

(787) 707-0095

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1275606071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19060",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009101060",
            "telephone_number": "787-707-0095",
            "fax_number": "787-707-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 GONZALEZ GUISTI AVE",
            "address_2": "CAPARRA GALLERY BLDG SUITE 305",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009663017",
            "telephone_number": "787-707-0095",
            "fax_number": "787-707-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON AND RECTAL SURGICAL GROUP OF PUERTO RICO PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "ULLOA",
        "authorized_official_first_name": "SANTIAGO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-707-0095"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "PR",
            "license": "10722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Colon & Rectal Surgery Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.