Provider Demographics
NPI:1467996595
Name:BELLA VISTA HOPITAL
Entity Type:Organization
Organization Name:BELLA VISTA HOPITAL
Other - Org Name:BELLA VISTA GASTROENTEROLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRATACOS NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-834-6000
Mailing Address - Street 1:PO BOX 1750
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1750
Mailing Address - Country:US
Mailing Address - Phone:787-834-6000
Mailing Address - Fax:787-831-6315
Practice Address - Street 1:CARR 349 KM 2.7
Practice Address - Street 2:CERRO LAS MESAS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681-1750
Practice Address - Country:US
Practice Address - Phone:787-834-6000
Practice Address - Fax:787-831-6315
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELLA VISTA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty