Healthcare Provider Details

I. General information

NPI: 1912057126
Provider Name (Legal Business Name): MUNICIPALITY OF SAN GERMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 CALLE GOLONDRINA URB. SANTA MARIA
SAN GERMAN PR
00683-4701
US

IV. Provider business mailing address

INTERAMERICAN UNIVERSITY AVE # 136
SAN GERMAN PR
00683
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-5620
  • Fax: 787-892-5710
Mailing address:
  • Phone: 787-892-3500
  • Fax: 787-892-1060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberTC AMB 441
License Number StatePR

VIII. Authorized Official

Name: ELI E ORTIZ
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 787-892-3500