Healthcare Provider Details

I. General information

NPI: 1003366527
Provider Name (Legal Business Name): CENTRO DE CANCER DE LA UNIVERSIDAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR21 INT PR18 BO MONACILLOS
SAN JUAN PR
00927
US

IV. Provider business mailing address

PO BOX 363027
SAN JUAN PR
00936-3027
US

V. Phone/Fax

Practice location:
  • Phone: 787-772-8300
  • Fax: 787-758-2557
Mailing address:
  • Phone: 787-772-8300
  • Fax: 787-758-2557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number StatePR

VIII. Authorized Official

Name: MRS. ELBA ALICEA
Title or Position: DIRECTOR
Credential:
Phone: 787-772-8300