Healthcare Provider Details

I. General information

NPI: 1609357532
Provider Name (Legal Business Name): HOSPITAL GENERAL DE CASTANER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 135 KM 64.2
CASTANER PR
00631
US

IV. Provider business mailing address

PO BOX 1003
CASTANER PR
00631-1003
US

V. Phone/Fax

Practice location:
  • Phone: 787-829-5010
  • Fax:
Mailing address:
  • Phone: 787-829-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. GUILLERMO J JIMENEZ
Title or Position: CFO
Credential:
Phone: 787-829-5010