Provider Demographics
NPI:1922076058
Name:INSTITUTO DE HEMATOLOGIA Y ONCOLOGIA MEDICA, SRL
Entity Type:Organization
Organization Name:INSTITUTO DE HEMATOLOGIA Y ONCOLOGIA MEDICA, SRL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:O
Authorized Official - Last Name:VELEZ-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-399-2424
Mailing Address - Street 1:PO BOX 9021257
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-1257
Mailing Address - Country:US
Mailing Address - Phone:787-250-7338
Mailing Address - Fax:787-764-6397
Practice Address - Street 1:#1789 CARRETERA 21 -
Practice Address - Street 2:TORRE HOSPITAL METROPOLITANO - URBANIZACIONLAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922
Practice Address - Country:US
Practice Address - Phone:787-250-7338
Practice Address - Fax:787-764-6397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084987Medicare PIN
PR0087912Medicare PIN