Provider Demographics
NPI:1861596496
Name:NEFROLOGOS ASOCIADOS DEL OESTE
Entity type:Organization
Organization Name:NEFROLOGOS ASOCIADOS DEL OESTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-5334
Mailing Address - Street 1:1050 LOS CORAZONES AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-7042
Mailing Address - Country:US
Mailing Address - Phone:787-834-5934
Mailing Address - Fax:787-833-6640
Practice Address - Street 1:1050 LOS CORAZONES AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-7042
Practice Address - Country:US
Practice Address - Phone:787-834-5934
Practice Address - Fax:787-833-6640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084991Medicare ID - Type Unspecified
PR0084992Medicare ID - Type Unspecified
PR0084924Medicare ID - Type Unspecified
PR0024175Medicare ID - Type Unspecified
PR0022332Medicare ID - Type Unspecified
PR0084993Medicare ID - Type Unspecified