Provider Demographics
NPI:1851773402
Name:SERVICIOS MEDICOS UNIVERSITARIOS
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS UNIVERSITARIOS
Other - Org Name:HOSPITAL UPR, DR. FEDERICO TRILLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIRAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-757-1800
Mailing Address - Street 1:PO BOX 6021
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-6021
Mailing Address - Country:US
Mailing Address - Phone:787-757-1800
Mailing Address - Fax:787-276-2205
Practice Address - Street 1:CARR. #3 KM. 8.3 AVE 65 INFANTERIA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:787-276-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400112Medicare Oscar/Certification