MEDICARE: HOSPITAL AUXILIO MUTUO

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	282N00000X	General Acute Care Hospital	31765	PR

General Provider Information

NPI Number	:	1346695020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL AUXILIO MUTUO

Provider Business Mailing Address
First Line	:	7 CALLE 3
Second Line	:	VILLA LOS OLMOS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4627
Country	:	US
Telephone Number	:	787-342-7504
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE PONCE DE LEON # 37.5
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00915-3959
Country	:	US
Telephone Number	:	787-758-2000
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	DR. FRANCISCO DIAZ LOZADA
Credential	:	M.D.
Telephone Number	:	787-758-2000

Provider Enumeration Date	:	04/29/2016
Last Update Date	:	04/29/2016

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