Provider Demographics
NPI:1003876954
Name:MUNICIPIO DE JAYUYA
Entity Type:Organization
Organization Name:MUNICIPIO DE JAYUYA
Other - Org Name:CENTRO DE SALUD MARIO CANALES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ETC
Authorized Official - Phone:787-828-0900
Mailing Address - Street 1:2 CALLE ROSANTA AULET
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664-1328
Mailing Address - Country:US
Mailing Address - Phone:787-828-0305
Mailing Address - Fax:787-828-0901
Practice Address - Street 1:2 CALLE ROSANTA AULET
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-1328
Practice Address - Country:US
Practice Address - Phone:787-828-0503
Practice Address - Fax:787-828-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRCNC NUM. 04-116282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR890487OtherMMM
PR030480OtherCRUZ AZUL
PA10-0170-1OtherACAA
PR4249-2OtherPROSAM
PR6640029OtherHUMANA
PR=========OtherCOSVIMED
PR=========OtherAMERICAN HEALTH
PR=========OtherMEDICAL CARD SYSTEM
PA10-0170-1OtherACAA
PR890487OtherMMM
PR=========OtherAMERICAN HEALTH