Basic Information
Provider Information
NPI: 1104862044
EntityType: 2
ReplacementNPI:  
OrganizationName: HOSPITAL DR. SUSONI. INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 145200
Address2:  
City: ARECIBO
State: PR
PostalCode: 006145200
CountryCode: US
TelephoneNumber: 7876501030
FaxNumber: 7876501040
Practice Location
Address1: 55 CALLE PALMA
Address2:  
City: ARECIBO
State: PR
PostalCode: 006124526
CountryCode: US
TelephoneNumber: 7876501030
FaxNumber: 7876501040
Other Information
ProviderEnumerationDate: 06/21/2006
LastUpdateDate: 08/03/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALVAREZ
AuthorizedOfficialFirstName: ANGEL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EXECUTIVE DIRECTOR
AuthorizedOfficialTelephone: 7876501031
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MHSA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X32CNC04196PRY HospitalsGeneral Acute Care Hospital 

No ID Information.


Home