Healthcare Provider Details

I. General information

NPI: 1306036272
Provider Name (Legal Business Name): DRA HILDA RIVERA QUINONES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE WASHINGTON ASHFORD MEDICAL CENTER SUITE 604
SANTURCE PR
00907-1510
US

IV. Provider business mailing address

CC16 CALLE G URB SANTA ELENA
BAYAMON PR
00957-1742
US

V. Phone/Fax

Practice location:
  • Phone: 787-725-6356
  • Fax: 787-724-3527
Mailing address:
  • Phone: 787-725-6356
  • Fax: 787-724-3527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number12855
License Number StatePR

VIII. Authorized Official

Name: DR. HILDA E RIVERA QUINONES
Title or Position: PRESIDENT
Credential:
Phone: 787-725-6356