Basic Information
| Provider Information | |||||||||
| NPI: | 1346695020 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL AUXILIO MUTUO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 CALLE 3 | ||||||||
| Address2: | VILLA LOS OLMOS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009274627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873427504 | ||||||||
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| Practice Location | |||||||||
| Address1: | AVE PONCE DE LEON # 37.5 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009153959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2016 | ||||||||
| LastUpdateDate: | 04/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | DIAZ LOZADA | ||||||||
| AuthorizedOfficialFirstName: | FRANCISCO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7877582000 | ||||||||
| 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 | 282N00000X | 31765 | PR | Y | Hospitals | General Acute Care Hospital |
No ID Information.