Healthcare Provider Details

I. General information

NPI: 1477191096
Provider Name (Legal Business Name): HPM FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 07/10/2024
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 AVE PONCE DE LEON BO AMELIA
GUAYNABO PR
00965-5602
US

IV. Provider business mailing address

PO BOX 14457
SAN JUAN PR
00916-4457
US

V. Phone/Fax

Practice location:
  • Phone: 787-773-1133
  • Fax: 787-919-3956
Mailing address:
  • Phone: 787-268-4171
  • Fax: 787-919-3956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: IVONNE RIVERA
Title or Position: CEO
Credential:
Phone: 787-268-4171