Provider Demographics
NPI:1629012828
Name:RYDER M. HOSPITAL
Entity Type:Organization
Organization Name:RYDER M. HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PRACTTIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-213-0037
Mailing Address - Street 1:2114 CALLE ANTIOQUIA
Mailing Address - Street 2:ALTO APOLO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4930
Mailing Address - Country:US
Mailing Address - Phone:502-213-0037
Mailing Address - Fax:
Practice Address - Street 1:2114 CALLE ANTIOQUIA
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4930
Practice Address - Country:US
Practice Address - Phone:502-213-0037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4614282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR79-444Medicare UPIN