Provider Demographics
NPI:1730835349
Name:NLA ENDO SERVICES LLC
Entity type:Organization
Organization Name:NLA ENDO SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COLON AND RECTAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS, FASCRS
Authorized Official - Phone:787-724-9595
Mailing Address - Street 1:400 F.D. ROOSEVELT AVE.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-724-9595
Mailing Address - Fax:
Practice Address - Street 1:400 F.D. ROOSEVELT AVE.
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-724-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty