Provider Demographics
NPI:1275606170
Name:SLEEP DISORDERS CENTER OF PR
Entity Type:Organization
Organization Name:SLEEP DISORDERS CENTER OF PR
Other - Org Name:HECTOR J STELLA - ESTEREZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-707-0020
Mailing Address - Street 1:107 GONZALEZ GUISTI AVE.
Mailing Address - Street 2:CAPARRA GALLERY BUILDING ,SUITE 304
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-707-0020
Mailing Address - Fax:787-782-2056
Practice Address - Street 1:107 GONZALEZ GUISTI AVE
Practice Address - Street 2:CAPARRA GALLERY BUILDING, SUITE 304
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-707-0020
Practice Address - Fax:787-782-2056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10812261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG89439Medicare UPIN
PR89938Medicare ID - Type UnspecifiedNUMERO DE PROVEEDOR