Healthcare Provider Details

I. General information

NPI: 1386793784
Provider Name (Legal Business Name): HOSPITAL EPISCOPAL SAN LUCAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

917 AVE TITO CASTRO P.O. BOX 336810
PONCE PR
00716-4717
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-2080
  • Fax: 787-843-4235
Mailing address:
  • Phone: 787-844-2080
  • Fax: 787-843-4235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. EDGAR CARLOS BELMONTE
Title or Position: PATHOLOGIST
Credential: MD
Phone: 787-844-2080