| Gastro Atenas LLC | |
|
93 Paseo Atenas Manati PR 00674-5368 | |
| (787) 854-7363 | |
| Not Available |
| Full Name | Gastro Atenas LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 93 Paseo Atenas, Manati, Puerto Rico |
| Authorized Official Name and Position | Rafael Tirado (CEO) |
| Authorized Official Contact | 7872268142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastro Atenas LLC 1511 Ave Ponce De Leon Apt 1243 Cond Ciudadela San Juan PR 00909-5001 | Gastro Atenas LLC 93 Paseo Atenas Manati PR 00674-5368 Ph: (787) 854-7363 |
| NPI Number | 1306392337 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 08/30/2016 |
| Medicare PECOS PAC ID | 4688952831 |
|---|---|
| Medicare Enrollment ID | O20161024001037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306392337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 20618 (Puerto Rico) | Primary |
| Provider Name | Rafael A. Tirado-montijo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1285947127 PECOS PAC ID: 4880993393 Enrollment ID: I20160505000654 |
| Provider Name | Roberto J Rodriguez Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154853604 PECOS PAC ID: 2163880352 Enrollment ID: I20230620003441 |
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