Provider Demographics
NPI:1447451232
Name:METROPOLITAN OTORINOLARINGOLOGY GROUP
Entity type:Organization
Organization Name:METROPOLITAN OTORINOLARINGOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSATVO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:MELERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-706-1315
Mailing Address - Street 1:URB. FLORES MONTEHIEDRA
Mailing Address - Street 2:BLVD. DE LA MONTANA APT 643
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-706-1315
Mailing Address - Fax:787-781-5923
Practice Address - Street 1:HOSPITAL METROPOLITANO SUITE 206
Practice Address - Street 2:CARR. 21 #1785 LAS LOMAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-706-1315
Practice Address - Fax:787-781-5923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13177207YS0012X
231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep MedicineGroup - Multi-Specialty
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9210029OtherHUMANA INSURANCE
PR9909OtherINTERNATIONAL MEDICAL
PR9210029OtherHUMANA HEALTH PLAN
PR250069OtherPREFERRED HELATH PLAN