Provider Demographics
NPI:1205029709
Name:MUNICIPIO DE GUANICA
Entity Type:Organization
Organization Name:MUNICIPIO DE GUANICA
Other - Org Name:CENTRO DE SALUD JUAN M. SANTIAGO
Other - Org Type:Other Name
Authorized Official - Title/Position:MAJOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-821-2777
Mailing Address - Street 1:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-0785
Mailing Address - Country:US
Mailing Address - Phone:787-821-1481
Mailing Address - Fax:787-821-0402
Practice Address - Street 1:CARRETERA 116 KM. 27.7
Practice Address - Street 2:
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653
Practice Address - Country:US
Practice Address - Phone:787-821-0402
Practice Address - Fax:787-821-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care