Provider Demographics
NPI:1760664643
Name:METRO HATO REY INC
Entity Type:Organization
Organization Name:METRO HATO REY INC
Other - Org Name:HOSPITAL PAVIA HATO REY-BEHAVIOR
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:SOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-641-2323
Mailing Address - Street 1:PO BOX 190828
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0828
Mailing Address - Country:US
Mailing Address - Phone:787-641-2323
Mailing Address - Fax:787-756-6747
Practice Address - Street 1:AVE. PONCE DE LEON #435
Practice Address - Street 2:FLOORS 4TH & 5TH
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-641-2323
Practice Address - Fax:787-756-6747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR71273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40S128OtherMEDICARE
PR40S128Medicare Oscar/Certification