Healthcare Provider Details

I. General information

NPI: 1538211321
Provider Name (Legal Business Name): REITTER CORPORATION HOSPITAL SAN GERARDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 AVE WINSTON CHURCHILL MSC 250
SAN JUAN PR
00926-6013
US

IV. Provider business mailing address

138 AVE WINSTON CHURCHILL MSC 250
SAN JUAN PR
00926-6013
US

V. Phone/Fax

Practice location:
  • Phone: 787-761-8383
  • Fax: 787-292-8260
Mailing address:
  • Phone:
  • Fax: 787-292-8260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number5
License Number StatePR

VIII. Authorized Official

Name: JOSE IVAN MORALES
Title or Position: GERENTE
Credential:
Phone: 787-761-8383