Healthcare Provider Details

I. General information

NPI: 1619215126
Provider Name (Legal Business Name): SAN JUAN CITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN JUAN CITY HOSPITAL, PEDIATRIC DEPARTMENT
SAN JUAN PR
00936-8344
US

IV. Provider business mailing address

SAN JUAN CITY HOSPITAL, PEDIATRIC DEPARTMENT
SAN JUAN PR
00936-8344
US

V. Phone/Fax

Practice location:
  • Phone: 787-480-5883
  • Fax:
Mailing address:
  • Phone: 305-877-1522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number014479I
License Number StatePR

VIII. Authorized Official

Name: DR. SILVIA CAROLINA LO WONG
Title or Position: RESIDENT
Credential: M.D.
Phone: 305-877-1522