Provider Demographics
NPI:1679509780
Name:HOSPITAL MENONITA DE CAYEY
Entity Type:Organization
Organization Name:HOSPITAL MENONITA DE CAYEY
Other - Org Name:CENTRO RENAL HOSPITAL MENONITA
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-535-1001
Mailing Address - Street 1:PO BOX 373130
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-3130
Mailing Address - Country:US
Mailing Address - Phone:787-535-1001
Mailing Address - Fax:787-535-1021
Practice Address - Street 1:BO RINCON SECTOR LOMAS CARRETERA 14
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:787-535-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR402314Medicare Oscar/Certification