Healthcare Provider Details

I. General information

NPI: 1275746513
Provider Name (Legal Business Name): HOSPITAL FONT MARTELO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SALA DE EMERGENCIA HIMA-HUMACAO FONT MARTELO ST.
HUMACAO PR
00792
US

IV. Provider business mailing address

100 GRAND BLVD PASEOS SUITE 401
SAN JUAN PR
00926-5955
US

V. Phone/Fax

Practice location:
  • Phone: 787-653-3434
  • Fax:
Mailing address:
  • Phone: 787-292-0600
  • Fax: 787-761-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAYMOND SEPULVEDA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 787-292-0600