Basic Information
| Provider Information | |||||||||
| NPI: | 1588693022 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL DAMAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 286 CALLE MONTERREY | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007160377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878408686 | ||||||||
| FaxNumber: | 7872597364 | ||||||||
| Practice Location | |||||||||
| Address1: | 2213 PONCE BY PASS | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007171318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8788408686 | ||||||||
| FaxNumber: | 7872597364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | VICENS | ||||||||
| AuthorizedOfficialFirstName: | ENRIQUE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRADOR & COO | ||||||||
| AuthorizedOfficialTelephone: | 7878402395 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MHSA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BP3500X | PR | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition |
No ID Information.