Provider Demographics
NPI:1629749890
Name:BELLA VISTA HOSPITAL, INC
Entity Type:Organization
Organization Name:BELLA VISTA HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRATACOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-834-2350
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:787-834-2350
Mailing Address - Fax:
Practice Address - Street 1:CARR 349 KM 2.9 CERRO LAS MESAS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-0068
Practice Address - Country:US
Practice Address - Phone:787-834-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELLA VISTA HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty