Healthcare Provider Details

I. General information

NPI: 1396022349
Provider Name (Legal Business Name): FIRST HOSPITAL PANAMERICANO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 08/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STATE ROAD 787, KM 1.5
CIDRA PR
00739
US

IV. Provider business mailing address

STATE ROAD 787, KM 1.5
CIDRA PR
00739
US

V. Phone/Fax

Practice location:
  • Phone: 787-739-5555
  • Fax:
Mailing address:
  • Phone: 787-739-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number16
License Number StatePR

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: CFO/SVP
Credential:
Phone: 610-768-3300