Healthcare Provider Details

I. General information

NPI: 1205690823
Provider Name (Legal Business Name): HILLUMED SRL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 METROS NORTE DE LA SODA LOCAL MANO IZQUIERDA
JACO PUNTARENAS
99999
CR

IV. Provider business mailing address

PO BOX 11577
FORT LAUDERDALE FL
33339-1577
US

V. Phone/Fax

Practice location:
  • Phone: 506-402-0220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: DIXAN GONZALEZ
Title or Position: COO
Credential:
Phone: 954-526-9751