| PR Oncology LLC | |
|
97 Ave De Diego San Juan PR 00927-6310 | |
| (939) 545-6353 | |
| (939) 545-6354 |
| Full Name | PR Oncology LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 97 Ave De Diego, San Juan, Puerto Rico |
| Authorized Official Name and Position | Luis Baez Vallecillo (PRESIDENTE) |
| Authorized Official Contact | 9395456353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| PR Oncology LLC 97 Ave De Diego San Juan PR 00927-6310 Ph: (787) 919-7919 | PR Oncology LLC 97 Ave De Diego San Juan PR 00927-6310 Ph: (939) 545-6353 |
| NPI Number | 1144842659 |
|---|---|
| Provider Enumeration Date | 05/07/2020 |
| Last Update Date | 08/16/2025 |
| Certification Date | 08/16/2025 |
| Medicare PECOS PAC ID | 2163843111 |
|---|---|
| Medicare Enrollment ID | O20200601000345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144842659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 207RH0003X | Internal Medicine - Hematology & Oncology | () | Primary |
| Provider Name | Luis Baez Vallecillo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1265788855 PECOS PAC ID: 1759523707 Enrollment ID: I20180306001531 |
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