Basic Information
| Provider Information | |||||||||
| NPI: | 1932171790 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MUNICIPIO DE MAUNABO | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | CDS MAUNABO | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | AVENIDA KENNEDY | ||||||||
| Address2: | APORTADO 8 | ||||||||
| City: | MAUNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878611407 | ||||||||
| FaxNumber: | 7878611407 | ||||||||
| Practice Location | |||||||||
| Address1: | AVENIDA KENNEDY | ||||||||
| Address2: | APORTADO 8 | ||||||||
| City: | MAUNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878611407 | ||||||||
| FaxNumber: | 7878611407 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 10/24/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MARQUEZ PEREZ | ||||||||
| AuthorizedOfficialFirstName: | JORGE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | MAYOR | ||||||||
| AuthorizedOfficialTelephone: | 7878610810 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | 50 | PR | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.