Healthcare Provider Details

I. General information

NPI: 1164738167
Provider Name (Legal Business Name): GHP C.S.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 CALLE SAN JORGE HOSPITAL SAN JORGE
SANTURCE PR
00912
US

IV. Provider business mailing address

130 AVE WINSTON CHURCHILL PMB 108
SAN JUAN PR
00926-6018
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAVIER CUEVAS MARRERO
Title or Position: PRESIDENT
Credential:
Phone: 787-946-1863