Basic Information
| Provider Information | |||||||||
| NPI: | 1972531218 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR SUSONI HEALTH COMMUNITY SERVICES CORP | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HOSPITAL PAVIA ARECIBO | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 659 | ||||||||
| Address2: | |||||||||
| City: | ARECIBO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006130659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876507272 | ||||||||
| FaxNumber: | 7876507310 | ||||||||
| Practice Location | |||||||||
| Address1: | AVE SAN LUIS | ||||||||
| Address2: | CARR 129 KM 0.1 | ||||||||
| City: | ARECIBO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876507272 | ||||||||
| FaxNumber: | 7876507310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 09/03/2019 | ||||||||
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| AuthorizedOfficialLastName: | ORTIZ | ||||||||
| AuthorizedOfficialFirstName: | HECTOR | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | FINANCE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7876507272 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2CNC00143 | PR | Y | Hospitals | General Acute Care Hospital |
No ID Information.