Provider Demographics
NPI:1154309169
Name:INSTITUTO MEDICO DEL NORTE INC
Entity Type:Organization
Organization Name:INSTITUTO MEDICO DEL NORTE INC
Other - Org Name:CENTRO MEDICO WILMA N VAZQUEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:IT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:787-858-1580
Mailing Address - Street 1:CALL BOX 7001
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-7001
Mailing Address - Country:US
Mailing Address - Phone:787-858-1580
Mailing Address - Fax:787-858-2385
Practice Address - Street 1:CARR 2 KM 39 5 BO ALGARROBO
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-858-1580
Practice Address - Fax:787-858-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR69282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400115Medicare Oscar/Certification