MEDICARE: HOSPICIO KRYSTAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency		PR

General Provider Information

NPI Number	:	1235635731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICIO KRYSTAL INC

Provider Business Mailing Address
First Line	:	PO BOX 515
Second Line	:
City	:	NARANJITO
State	:	PR
Zip	:	00719-0515
Country	:	US
Telephone Number	:	787-869-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE LA CANDELARIA #8
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-5043
Country	:	US
Telephone Number	:	787-805-6325
Fax Number	:	787-805-6301

Authorized Official
Title or Position	:	CEO
Name	:	MRS. GLORIA DEL C AMADOR FERNANDEZ
Credential	:
Telephone Number	:	787-869-5900

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	04/01/2025

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