Provider Demographics
NPI:1588220842
Name:HOSPICIO BONILLA L.L.C.
Entity Type:Organization
Organization Name:HOSPICIO BONILLA L.L.C.
Other - Org Name:HOSPICIO BONILLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-424-5533
Mailing Address - Street 1:29 CALLE BASILIO CATALA
Mailing Address - Street 2:COND PRADOS DEL MONTE APT 709
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-424-5533
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL HIMA-SAN PABLO CAGUAS
Practice Address - Street 2:FACULTAD MEDICA HIMA SP-CAGUAS APARTADO 4980
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:787-961-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
No315D00000XNursing & Custodial Care FacilitiesHospice, InpatientGroup - Single Specialty