Healthcare Provider Details

I. General information

NPI: 1952973042
Provider Name (Legal Business Name): HOSPITAL MENONITA CAGUAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB TURABO GARDENS SALIDA 21 CARRETERA CAGUAS A CIDRAS
CAGUAS PR
00725-8888
US

IV. Provider business mailing address

PO BOX 1650
CIDRA PR
00739-1650
US

V. Phone/Fax

Practice location:
  • Phone: 787-434-1700
  • Fax: 787-434-1711
Mailing address:
  • Phone: 787-434-1700
  • Fax: 787-434-1711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: LISSETTE VASQUEZ RIVERA
Title or Position: DIRECTOR OF BILLING AND COLLECTOR
Credential:
Phone: 787-434-1700