Provider Demographics
NPI:1215368204
Name:SISTEMA UNIVERSITARIO ANA G MENDEZ
Entity Type:Organization
Organization Name:SISTEMA UNIVERSITARIO ANA G MENDEZ
Other - Org Name:COMMUNITY HEALTH PROMOTION SERVICES CENTER / UNE SALUD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ADVISER
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGOSTO
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:787-257-7373
Mailing Address - Street 1:PO BOX 2010
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984
Mailing Address - Country:US
Mailing Address - Phone:787-257-7373
Mailing Address - Fax:
Practice Address - Street 1:PR 190 KM 1.8 SABANA ABAJO
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984-2010
Practice Address - Country:US
Practice Address - Phone:787-257-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology