Provider Demographics
NPI:1548417579
Name:MUNICIPIO AUTONOMO DE GUAYNABO
Entity Type:Organization
Organization Name:MUNICIPIO AUTONOMO DE GUAYNABO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUB-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZULEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:939-639-2555
Mailing Address - Street 1:PO BOX 7885
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970
Mailing Address - Country:US
Mailing Address - Phone:939-639-2555
Mailing Address - Fax:
Practice Address - Street 1:45 DIEGO VEGA ST., BARRIO AMELIA
Practice Address - Street 2:VACCINE CENTER
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970
Practice Address - Country:US
Practice Address - Phone:939-639-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center