Healthcare Provider Details

I. General information

NPI: 1174551154
Provider Name (Legal Business Name): HATO REY HEMATOLOGY ONCOLOGY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 PONCE DE LEON SUITE 701
SAN JUAN PR
00917-5025
US

IV. Provider business mailing address

PO BOX 11965
SAN JUAN PR
00922-1965
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-6225
  • Fax: 787-756-7853
Mailing address:
  • Phone: 787-758-6225
  • Fax: 787-756-7853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RAFAEL RIVERA
Title or Position: ADMINISTRATOR
Credential: MHSA
Phone: 787-758-6225