Provider Demographics
NPI:1609868645
Name:HOSPICIO LA PAZ INC
Entity Type:Organization
Organization Name:HOSPICIO LA PAZ INC
Other - Org Name:AZTIN SERVICIOS DE SALUD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONROUZEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:800-981-0032
Mailing Address - Street 1:152 CALLE JOSE RODRIGUEZ IRIZARRY
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:800-981-0032
Mailing Address - Fax:787-880-0832
Practice Address - Street 1:152 CALLE JOSE RODRIGUEZ IRIZARRY
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:800-981-0032
Practice Address - Fax:787-880-0832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6120115OtherHUMANA HEALTH PLANS
PR68298HOOtherTRIPLE-S
PR6120115OtherHUMANA HEALTH PLANS
PR=========OtherFIRST MEDICAL HEALTH PLAN
PR401527Medicare ID - Type Unspecified