Provider Demographics
NPI:1669784245
Name:CAPITAL OB-GYN GROUP, P.S.C.
Entity type:Organization
Organization Name:CAPITAL OB-GYN GROUP, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAURY
Authorized Official - Middle Name:
Authorized Official - Last Name:LLORENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-910-1555
Mailing Address - Street 1:PO BOX 10255
Mailing Address - Street 2:CAPARRA HEIGHT STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-0255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAN JUAN HOSPITAL
Practice Address - Street 2:RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00928
Practice Address - Country:US
Practice Address - Phone:787-767-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13371207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty