Provider Demographics
NPI:1467417865
Name:METRO SANTURCE, INC.
Entity Type:Organization
Organization Name:METRO SANTURCE, INC.
Other - Org Name:HOSPITAL PAVIA SANTURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-641-2038
Mailing Address - Street 1:PO BOX 11137
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-2237
Mailing Address - Country:US
Mailing Address - Phone:787-727-6060
Mailing Address - Fax:787-727-4202
Practice Address - Street 1:1462 PROF AUGUSTO RODRIGUEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00910-2237
Practice Address - Country:US
Practice Address - Phone:787-727-6060
Practice Address - Fax:787-727-4202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR60282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
400019Medicare ID - Type Unspecified