Healthcare Provider Details

I. General information

NPI: 1568565471
Provider Name (Legal Business Name): BELLA VISTA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 349 KM2.7 CERRO LAS MESAS
MAYAGUEZ PR
00680-1750
US

IV. Provider business mailing address

5 BELLA VISTA GDNS
MAYAGUEZ PR
00680-8312
US

V. Phone/Fax

Practice location:
  • Phone: 787-652-6045
  • Fax: 787-831-6315
Mailing address:
  • Phone: 787-652-6045
  • Fax: 787-831-6315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberAPM126
License Number StatePR

VIII. Authorized Official

Name: LUIS RIVERA
Title or Position: DIRECTOR
Credential:
Phone: 787-834-6000