Healthcare Provider Details

I. General information

NPI: 1528360237
Provider Name (Legal Business Name): SAN JUAN CITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2010
Last Update Date: 12/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 CALLE VIOLETA CIUDAD JARDIN,
CAROLINA PR
00987-2205
US

IV. Provider business mailing address

VIOLET STREET #66 , CIUDAD JARDIN, #66
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-420-0150
  • Fax:
Mailing address:
  • Phone: 787-420-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number28260R
License Number StatePR

VIII. Authorized Official

Name: DR. VERONICA DEL RIO
Title or Position: PROGRAM DIRECTOR
Credential: M.D,
Phone: 787-765-7618