Healthcare Provider Details

I. General information

NPI: 1043563273
Provider Name (Legal Business Name): SAN JUAN MUNICIPAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDO MONTE REAL RR2 BUSON 187
SAN JUAN PR PUERTO RICO
00926
UM

IV. Provider business mailing address

MONTE REAL BUSON 187
SAN JUAN PR
00926-8211
US

V. Phone/Fax

Practice location:
  • Phone: 787-342-8393
  • Fax:
Mailing address:
  • Phone: 787-342-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number014309-1
License Number StatePR

VIII. Authorized Official

Name: DR. IGAL PALMA
Title or Position: RESIDENT
Credential: M.D.
Phone: 787-342-8393