| Ag Thyroid & Endocrine Clinic Llc | |
|
1801 Ave Ponce De Leon San Juan PR 00909-1900 | |
| (787) 726-1100 | |
| Not Available |
| Full Name | Ag Thyroid & Endocrine Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1801 Ave Ponce De Leon, San Juan, Puerto Rico |
| Authorized Official Name and Position | Alex N Gonzalez Bossolo (PRESIDENT) |
| Authorized Official Contact | 7877261100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ag Thyroid & Endocrine Clinic Llc 1801 Ave Ponce De Leon San Juan PR 00909-1900 Ph: (787) 726-1100 | Ag Thyroid & Endocrine Clinic Llc 1801 Ave Ponce De Leon San Juan PR 00909-1900 Ph: (787) 726-1100 |
| NPI Number | 1275036451 |
|---|---|
| Provider Enumeration Date | 03/14/2018 |
| Last Update Date | 03/14/2018 |
| Medicare PECOS PAC ID | 5395098198 |
|---|---|
| Medicare Enrollment ID | O20181024002241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275036451 | NPI | - | NPPES |
| 11457606444 | Other | PR | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (Puerto Rico) | Primary |
| Provider Name | Alex N Gonzalez Bossolo |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1457606444 PECOS PAC ID: 7911251046 Enrollment ID: I20181108001213 |
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