Provider Demographics
NPI:1871270918
Name:GASTRO-HEPATOLOGY INSTITUTE OF PUERTO RICO LLC
Entity type:Organization
Organization Name:GASTRO-HEPATOLOGY INSTITUTE OF PUERTO RICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:HENDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-0101
Mailing Address - Street 1:1507 PASEOMONTE
Mailing Address - Street 2:381 AVE FELISA RICON DE GAUTIER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6665
Mailing Address - Country:US
Mailing Address - Phone:787-265-8152
Mailing Address - Fax:
Practice Address - Street 1:CALLE PERAL #14 EDIFICIO LA PALMA
Practice Address - Street 2:SUITE 1C
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-0000
Practice Address - Country:US
Practice Address - Phone:787-265-8152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant HepatologyGroup - Single Specialty