Provider Demographics
NPI:1336461672
Name:CENTRO DE HEMATOLOGIA Y ONCOLOGIA MEDICA ASHFORD PSC
Entity Type:Organization
Organization Name:CENTRO DE HEMATOLOGIA Y ONCOLOGIA MEDICA ASHFORD PSC
Other - Org Name:
Other - Org Type:
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:MD
Authorized Official - Phone:787-725-6356
Mailing Address - Street 1:ASHFORD AVE. WASHINGTON ST 29
Mailing Address - Street 2:SUITE 604
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1521
Mailing Address - Country:US
Mailing Address - Phone:787-725-6356
Mailing Address - Fax:787-724-3527
Practice Address - Street 1:ASHFORD AVE AND WASHINGTON ST 29
Practice Address - Street 2:SUITE 604
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-725-6356
Practice Address - Fax:787-724-3527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12855261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH48917Medicare UPIN