Basic Information
| Provider Information | |||||||||
| NPI: | 1780286542 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SERVICIOS DE ANESTESIA HOSPITAL SAN CARLOS BORROMEO | ||||||||
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| OtherOrganizationName: | SERVICES DE ANESTHESIA HOSPITAL SAN CARLOS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 68 | ||||||||
| Address2: | |||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006760068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878778000 | ||||||||
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| Practice Location | |||||||||
| Address1: | CARR. 110 BARRIO PUEBLO CALLE CONCEPCION VERA | ||||||||
| Address2: | #550 S | ||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006760068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878778000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2020 | ||||||||
| LastUpdateDate: | 02/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | CRESPO | ||||||||
| AuthorizedOfficialFirstName: | ROSAIDA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7878778000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SERVICIOS DE ANESTESIA HOSPITAL SAN CARLOS BORROMEO | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 02/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | N | Hospitals | General Acute Care Hospital | Rural | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.