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General NPI Number Information
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NPI Number | 1962948745
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Entity Type | Organization
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Legal Business Name | AUXILIO MUTUO HOSPITAL
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 83 CALLE PONCE
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City | SAN JUAN
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State | PR
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Zip | 00917-5007
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Country | US
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Telephone | 786-975-9767
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Fax |
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Provider Business Mailing Address
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Address Line | 83 CALLE PONCE
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City | SAN JUAN
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State | PR
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Zip | 00917-5007
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Country | US
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Telephone | 786-975-9767
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Fax |
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Authorized Official
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Title or Position | MEDICO INTERNO
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Name | WILMER COLUMBIE SARDINAS
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Credential | M.D
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Telephone | 786-975-9767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 14173I
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License Number State | PR
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