Provider Demographics
NPI:1750655510
Name:UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
Other - Org Name:HOSPITAL UPR
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR IN MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:KILSY
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:CUELLO PICHARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-292-2018
Mailing Address - Street 1:U20 JASPER STREET
Mailing Address - Street 2:PARK GARDENS URB.
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-9321
Mailing Address - Country:US
Mailing Address - Phone:787-759-8252
Mailing Address - Fax:
Practice Address - Street 1:U20 CALLE JASPER
Practice Address - Street 2:PARK GARDENS URB.
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2139
Practice Address - Country:US
Practice Address - Phone:787-759-8252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12985I282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital