Basic Information
| Provider Information | |||||||||
| NPI: | 1386793784 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL EPISCOPAL SAN LUCAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 917 AVE TITO CASTRO | ||||||||
| Address2: | P.O. BOX 336810 | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007164717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878442080 | ||||||||
| FaxNumber: | 7878434235 | ||||||||
| Practice Location | |||||||||
| Address1: | 917 AVE TITO CASTRO | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007164717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878442080 | ||||||||
| FaxNumber: | 7878434235 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BELMONTE | ||||||||
| AuthorizedOfficialFirstName: | EDGAR | ||||||||
| AuthorizedOfficialMiddleName: | CARLOS | ||||||||
| AuthorizedOfficialTitleorPosition: | PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 7878442080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.