Provider Demographics
NPI:1750316006
Name:CENTRO MEDICO DEL TURABO INC.
Entity Type:Organization
Organization Name:CENTRO MEDICO DEL TURABO INC.
Other - Org Name:HOSPITAL HIMA SAN PABLO FAJARDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN,CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:JD
Authorized Official - Phone:787-653-3434
Mailing Address - Street 1:PO BOX 4980
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4980
Mailing Address - Country:US
Mailing Address - Phone:787-653-3434
Mailing Address - Fax:787-653-1799
Practice Address - Street 1:404 AVE GENERAL VALERO
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3901
Practice Address - Country:US
Practice Address - Phone:787-655-0505
Practice Address - Fax:787-655-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRCNC 05-091282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
0081026OtherANESTHESIA MEDICARE
PRCNC 05-091OtherSTATE LICENSE
PRCNC 05-091OtherSTATE LICENSE