Healthcare Provider Details

I. General information

NPI: 1396244877
Provider Name (Legal Business Name): CAGUAS AMBULATORY SURGICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 01/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 156 KM 60.1
CAGUAS PR
07256
US

IV. Provider business mailing address

48 CARR 165 STE 1010
GUAYNABO PR
00968-8080
US

V. Phone/Fax

Practice location:
  • Phone: 787-376-8354
  • Fax: 787-376-8354
Mailing address:
  • Phone: 787-376-8354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGIE L JIMENEZ
Title or Position: CEO / ADMINISTRATOR
Credential: MHSA
Phone: 787-376-8354