Basic Information
Provider Information
NPI: 1821342817
EntityType: 2
ReplacementNPI:  
OrganizationName: HOSPITAL SAN ANTONIO, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: RAMON E BETANCES # 18 NORTH
Address2: PO BOX 546
City: MAYAGUEZ
State: PR
PostalCode: 006810546
CountryCode: US
TelephoneNumber: 7878340050
FaxNumber: 7878342104
Practice Location
Address1: RAMON E BETANCES # 18 NORTH
Address2:  
City: MAYAGUEZ
State: PR
PostalCode: 006810546
CountryCode: US
TelephoneNumber: 7878340050
FaxNumber: 7878342104
Other Information
ProviderEnumerationDate: 10/30/2012
LastUpdateDate: 10/30/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MARTINEZ
AuthorizedOfficialFirstName: FRANCISCO
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EXECUTIVE ADMINISTRATOR
AuthorizedOfficialTelephone: 7878340050
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X29PRY HospitalsGeneral Acute Care Hospital 

No ID Information.


Home