Basic Information
| Provider Information | |||||||||
| NPI: | 1891467429 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SERVICIOS HOSPITALISTAS SAN CARLOS BORROMEO | ||||||||
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| Mailing Information | |||||||||
| Address1: | MENDEZ VIGO 410 OFICINA 103 | ||||||||
| Address2: | |||||||||
| City: | DORADO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873305424 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 CALLE CONCEPCION VERA | ||||||||
| Address2: | |||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006765005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878778000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2021 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | RODRIGUEZ | ||||||||
| AuthorizedOfficialFirstName: | JANICE | ||||||||
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| AuthorizedOfficialTitleorPosition: | FACTURACION MEDICA | ||||||||
| AuthorizedOfficialTelephone: | 7873305424 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HOSPITAL SAN CARLOS INCORPORADO | ||||||||
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| NPICertificationDate: | 09/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.