Healthcare Provider Details

I. General information

NPI: 1306529805
Provider Name (Legal Business Name): SAINT LUKES MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

PO BOX 336810
PONCE PR
00733-6810
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-2080
  • Fax: 787-844-2090
Mailing address:
  • Phone: 787-844-2080
  • Fax: 787-844-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ELYONEL PONTON CRUZ
Title or Position: PRINCIPAL EJECUTIVO OPERACIONAL
Credential:
Phone: 787-844-2080