Healthcare Provider Details

I. General information

NPI: 1780286542
Provider Name (Legal Business Name): SERVICIOS DE ANESTESIA HOSPITAL SAN CARLOS BORROMEO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 110 BARRIO PUEBLO CALLE CONCEPCION VERA #550 S
MOCA PR
00676-0068
US

IV. Provider business mailing address

PO BOX 68
MOCA PR
00676-0068
US

V. Phone/Fax

Practice location:
  • Phone: 787-877-8000
  • Fax:
Mailing address:
  • Phone: 787-877-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. ROSAIDA M CRESPO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-877-8000