Healthcare Provider Details

I. General information

NPI: 1306095492
Provider Name (Legal Business Name): HOSPITAL ONCOLOGICO DR.ISAAC GONZALEZ MARTINEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

D9 CALLE SEVILLA VISTAMAR MARINA ESTE
CAROLINA PR
00983-1522
US

IV. Provider business mailing address

D-9 CALLE SEVILLA VISTAMAR MARINA ESTE
CAROLINA PR
00983-1522
US

V. Phone/Fax

Practice location:
  • Phone: 787-243-8738
  • Fax:
Mailing address:
  • Phone: 787-243-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number11934
License Number StatePR

VIII. Authorized Official

Name: DR. LAURA MARTINEZ DE LUGO
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 787-243-8738