Provider Demographics
NPI:1114022431
Name:ANESTESIA DEL NORTE P.S.C.
Entity Type:Organization
Organization Name:ANESTESIA DEL NORTE P.S.C.
Other - Org Name:ANESTESIA DEL NORTE P.S.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ANESTESIOLOGO
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-621-3700
Mailing Address - Street 1:P.O. BOX 80
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-621-3700
Mailing Address - Fax:787-621-3712
Practice Address - Street 1:URB ATENAS CALLE HERNANDEZ CARRION #668
Practice Address - Street 2:MANATI
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:787-621-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11942174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR601236OtherMMM
PR84858OtherTRIPLE SSS. INC
PR84858OtherTRIPLE SSS. INC
PR601236OtherMMM
PR=========OtherPREFERED MEDICARE CHOISE
PR=========OtherCIGNA
PR89056Medicare ID - Type UnspecifiedMEDICARE