Healthcare Provider Details

I. General information

NPI: 1912987629
Provider Name (Legal Business Name): HOSPITAL SAN ANTONIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CALLE POST N
MAYAGUEZ PR
00680-6626
US

IV. Provider business mailing address

18 CALLE POST N PO BOX 546
MAYAGUEZ PR
00680-6626
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-0050
  • Fax: 787-834-2104
Mailing address:
  • Phone: 787-834-0050
  • Fax: 787-834-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number29
License Number StatePR

VIII. Authorized Official

Name: MRS. LINDA KAY ROY
Title or Position: BILLING DIRECTOR
Credential:
Phone: 787-834-0050