Provider Demographics
NPI:1306036272
Name:DRA HILDA RIVERA QUINONES
Entity Type:Organization
Organization Name:DRA HILDA RIVERA QUINONES
Other - Org Name:CENTRO DE HEMA & ONCO MED ASHFORD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIVERA QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-725-6356
Mailing Address - Street 1:CC16 CALLE G
Mailing Address - Street 2:URB SANTA ELENA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-1742
Mailing Address - Country:US
Mailing Address - Phone:787-725-6356
Mailing Address - Fax:787-724-3527
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:ASHFORD MEDICAL CENTER SUITE 604
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-725-6356
Practice Address - Fax:787-724-3527
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRA HILDA E. RIVERA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12855261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0020652Medicare PIN
H48917Medicare UPIN