Basic Information
Provider Information | |||||||||
NPI: | 1730159286 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | HOSPITAL DAMAS INC. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2213 PONCE BY PASS | ||||||||
Address2: |   | ||||||||
City: | PONCE | ||||||||
State: | PR | ||||||||
PostalCode: | 007171318 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7878408686 | ||||||||
FaxNumber: | 7878408686 | ||||||||
Practice Location | |||||||||
Address1: | 2213 PONCE BY PASS | ||||||||
Address2: |   | ||||||||
City: | PONCE | ||||||||
State: | PR | ||||||||
PostalCode: | 007171318 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7878408686 | ||||||||
FaxNumber: | 7878400089 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/26/2006 | ||||||||
LastUpdateDate: | 10/14/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | RIVERA | ||||||||
AuthorizedOfficialFirstName: | JULIO | ||||||||
AuthorizedOfficialMiddleName: | COLON | ||||||||
AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE | ||||||||
AuthorizedOfficialTelephone: | 7878408686 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 53 | PR | N |   | Hospitals | General Acute Care Hospital |   | 314000000X | 3 | PR | N |   | Nursing & Custodial Care Facilities | Skilled Nursing Facility |   | 282N00000X |   | PR | Y |   | Hospitals | General Acute Care Hospital |   |
No ID Information.