Caribbean Urogynecology Associates PSC

Organization Active NPI Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician · Guaynabo, PR

NPI 1699004366 · NPPES record last updated Aug 31, 2012

Key facts

NPI
1699004366
Entity type
Organization (NPI type 2)
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X
License
16233 (PR)
Legal business name
CARIBBEAN UROGYNECOLOGY ASSOCIATES PSC
Practice address
101 Ave San Patricio
Maramar Plaza Suite 1090
Guaynabo, PR 00968-2645
Phone
(787) 414-8777
Fax
(787) 963-0729
NPI assigned
Dec 9, 2009
Organization subpart
No

Authorized official

Name
Dr. Jimmy J Julia-Martinez, MD
Title
President
Phone
(787) 414-8777

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100518000377 PR Part B Supplier - Clinic/Group Practice 1052440740 Receives reassigned benefits from 1 practitioner
Practice locations: Guaynabo, PR

National Provider Directory

Locations

101 Ave San Patricio
Ste 1090
Guaynabo, PR 00968
Phone (787) 414-8777

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207VF0040X 16233 PR Yes

Addresses

Primary practice location

101 Ave San Patricio
Maramar Plaza Suite 1090
Guaynabo, PR 00968-2645

Mailing address

101 Ave San Patricio
Maramar Plaza Suite 1090
Guaynabo, PR 00968-2645
Phone (787) 414-8777

Other providers in Guaynabo, PR

All providers in Guaynabo, PR · Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.