Healthcare Provider Details

I. General information

NPI: 1841919974
Provider Name (Legal Business Name): SAN LUCAS METRO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 844, KM .5 CUPEY BAJO
SAN JUAN PR
00928-0000
US

IV. Provider business mailing address

PO BOX 336810
PONCE PR
00733-6810
US

V. Phone/Fax

Practice location:
  • Phone: 787-761-8383
  • Fax: 787-844-2090
Mailing address:
  • Phone: 787-761-8383
  • Fax: 787-844-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSEMARY DE LA CRUZ SEVERINO
Title or Position: PRINCIPAL FINANCE OFFICER
Credential:
Phone: 787-864-4300