Provider Demographics
NPI:1053299164
Name:PELVIC SOLUTION INSTITUTE, LLC
Entity type:Organization
Organization Name:PELVIC SOLUTION INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHORSANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-226-5425
Mailing Address - Street 1:PO BOX 6480
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6480
Mailing Address - Country:US
Mailing Address - Phone:787-226-5425
Mailing Address - Fax:
Practice Address - Street 1:1804 AVE PONCE DE LEON
Practice Address - Street 2:OFICINA 136-12
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-226-5425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryGroup - Multi-Specialty