Healthcare Provider Details

I. General information

NPI: 1225587207
Provider Name (Legal Business Name): GRUPO MEDICO HOSPITAL DAMAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2016
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 BY PASS
PONCE PR
00717-1318
US

IV. Provider business mailing address

2213 BY PASS
PONCE PR
00717-1318
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-8686
  • Fax: 787-840-8625
Mailing address:
  • Phone: 787-840-8686
  • Fax: 787-840-8625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number53
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID BONILLA
Title or Position: GERENTE DE CONTRATACIONES Y COBROS
Credential:
Phone: 787-840-8686