Provider Demographics
NPI:1750667572
Name:MUNICIPALITY OF SAN JUAN
Entity Type:Organization
Organization Name:MUNICIPALITY OF SAN JUAN
Other - Org Name:GRUPO MEDICO HOSPITAL MUNICIPAL SAN JUAN DR. RAFAEL LOPEZ NUSSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-480-2702
Mailing Address - Street 1:PMB 79 PO BOX 70344
Mailing Address - Street 2:SAN JUAN CITY HOSPITAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928
Mailing Address - Country:US
Mailing Address - Phone:787-756-8535
Mailing Address - Fax:787-764-3643
Practice Address - Street 1:BO. MONACILLOS CENTRO MEDICO
Practice Address - Street 2:RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-480-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR30261QM1300X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital