Provider Demographics
NPI:1548306426
Name:GRUPO DE CIRUGIA DOCTORS CENTER, CSP
Entity type:Organization
Organization Name:GRUPO DE CIRUGIA DOCTORS CENTER, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:GONZALEZ-MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-7545
Mailing Address - Street 1:PO BOX 1152
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1152
Mailing Address - Country:US
Mailing Address - Phone:787-854-7545
Mailing Address - Fax:787-854-6890
Practice Address - Street 1:TORRE DOCTORS' CENTER
Practice Address - Street 2:SUITE 201-202
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-7545
Practice Address - Fax:787-854-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR55842086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR26607Medicare ID - Type Unspecified