Healthcare Provider Details

I. General information

NPI: 1962219683
Provider Name (Legal Business Name): SAINT LUKES MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARKING CENTRO MEDICO LOCAL 9, 2DO PISO - PLAZA CENTRAL
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

PO BOX 336810
PONCE PR
00733-6810
US

V. Phone/Fax

Practice location:
  • Phone: 787-492-2020
  • Fax: 939-229-1017
Mailing address:
  • Phone: 787-492-2020
  • Fax: 939-229-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CARLOS M VALENTIN
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 787-754-8500