Provider Demographics
NPI:1710180005
Name:PPI DE SERVICIO DE OFICIAL MEDICO REVISOR Y CONSULTORIA LEGAL
Entity type:Organization
Organization Name:PPI DE SERVICIO DE OFICIAL MEDICO REVISOR Y CONSULTORIA LEGAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYVIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MRO
Authorized Official - Phone:787-318-1310
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-318-1310
Mailing Address - Fax:787-764-1760
Practice Address - Street 1:PISO 3 EDIFICIO DE ENFERMERIA, OFICINA 332
Practice Address - Street 2:RECINTO DE CIENCIAS MEDICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-318-1310
Practice Address - Fax:787-764-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8162207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8162OtherMEDICAL LICENSE