| San Pablo Gastroenterology Psc | |
|
28 Santa Cruz Street Torre San Pablo Suite 202-a Bayamon PR 00961 | |
| (787) 995-0500 | |
| (787) 785-0063 |
| Full Name | San Pablo Gastroenterology Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | 28 Santa Cruz Street, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Ricardo Juan Marrero (OWNER) |
| Authorized Official Contact | 7879950500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Pablo Gastroenterology Psc 425 Carr 693 Pmb 152 Dorado PR 00646-4816 Ph: (787) 995-0500 | San Pablo Gastroenterology Psc 28 Santa Cruz Street Torre San Pablo Suite 202-a Bayamon PR 00961 Ph: (787) 995-0500 |
| NPI Number | 1487035390 |
|---|---|
| Provider Enumeration Date | 06/16/2015 |
| Last Update Date | 06/16/2015 |
| Medicare PECOS PAC ID | 2264728633 |
|---|---|
| Medicare Enrollment ID | O20160912000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487035390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 16988 (Puerto Rico) | Primary |
| Provider Name | Ricardo J Marrero |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093998320 PECOS PAC ID: 7214010701 Enrollment ID: I20080206000562 |
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