Aesthetic Center of Puerto Rco CSP

Organization Active NPI Plastic and Reconstructive Surgery Physician · Humacao, PR

NPI 1295039626 · NPPES record last updated Dec 28, 2010

Key facts

NPI
1295039626
Entity type
Organization (NPI type 2)
Primary specialty
Plastic and Reconstructive Surgery Physician 2086S0122X
Legal business name
AESTHETIC CENTER OF PUERTO RCO CSP
Practice address
355 Ave Font Martelo
Hospital Ryder Oficina 402
Humacao, PR 00791-3249
Phone
(787) 850-8217
NPI assigned
Dec 28, 2010
Organization subpart
No

Authorized official

Name
Dr. Luis Ivan Morell
Title
Precident
Phone
(787) 850-8217

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

355 Ave Font Martelo
#402
Humacao, PR 00791
Phone (787) 850-8217

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2086S0122X Yes

Addresses

Primary practice location

355 Ave Font Martelo
Hospital Ryder Oficina 402
Humacao, PR 00791-3249

Mailing address

100 Grand Blvd Paseo
Suite 112 MSC 486
San Juan, PR 00926
Phone (787) 850-8217

Other identifiers

IdentifierTypeStateIssuer
20484MOMedicaidPR

Other providers in Humacao, PR

All providers in Humacao, PR · Plastic and Reconstructive Surgery Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.