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General NPI Number Information
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NPI Number | 1275473936
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Entity Type | Organization
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Legal Business Name | HOSPITAL REAL SAN JOSE
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | AV. CENTRAL NO. 911, COL. RESIDENCIAL PONIENTE
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City | ZAPOPAN
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State | JALISCO
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Zip | 45136
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Country | MX
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11597
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City | FORT LAUDERDALE
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State | FL
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Zip | 33339-1597
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | JOAQUIN JIMENEZ FLORES
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Credential |
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Telephone | 331-848-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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