ADVANCED ANTI AGING LLC NPI 1093226995

NPI Information

  • NPI: 1093226995
  • Provider Name: ADVANCED ANTI AGING LLC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Address: 29 WASHINGTON STREET ASHFORD MEDICAL CENTER
    SUITE 310
    SAN JUAN, PR
    ZIP 00907
  • Phone: (787) 400-9779

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NPI Details

ADVANCED ANTI AGING LLC is an obstetrics gynecology in San Juan, PR. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. ADVANCED ANTI AGING LLC NPI is 1093226995. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

29 WASHINGTON STREET ASHFORD MEDICAL CENTER
SUITE 310
SAN JUAN, PR
ZIP 00907
Phone: (787) 400-9779

The provider's authorized official is Jose L Lizardi .
The authorized official title is Doctor and has the following contact phone number (315) 244-1396.

The enumeration date for this NPI number is 10/18/2017 and was last updated on 10/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyPUERTO RICOYes

What is NPI?

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This page was last updated on: 11/21/2025

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