Healthcare Provider Details

I. General information

NPI: 1144362807
Provider Name (Legal Business Name): HOSTOS MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CALLE DE DIEGO W
MAYAGUEZ PR
00680-4736
US

IV. Provider business mailing address

PO BOX 1586
MAYAGUEZ PR
00681-1586
US

V. Phone/Fax

Practice location:
  • Phone: 787-265-3320
  • Fax: 787-265-2929
Mailing address:
  • Phone: 787-265-3320
  • Fax: 787-265-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StatePR

VIII. Authorized Official

Name: ORLANDO C PALMER MELLOWES
Title or Position: ADMINSTRATOR
Credential:
Phone: 787-215-6056