Basic Information
| Provider Information | |||||||||
| NPI: | 1679924021 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL UNIVERSITARIO DE ADULTOS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2116 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009222116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Practice Location | |||||||||
| Address1: | COND CENTRO PLZ | ||||||||
| Address2: | BO. MONACILLOS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009092110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2016 | ||||||||
| LastUpdateDate: | 06/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | MOSCOSO | ||||||||
| AuthorizedOfficialFirstName: | RICARDO | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7877540101 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 281P00000X | N | Hospitals | Chronic Disease Hospital | 286500000X | N | Hospitals | Military Hospital | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.