Provider Demographics
NPI:1922254952
Name:PROFESSIONAL HOSPITAL GUAYNABO INC
Entity Type:Organization
Organization Name:PROFESSIONAL HOSPITAL GUAYNABO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF GOVERNING BOARD
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:I
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-708-6560
Mailing Address - Street 1:PO BOX 1609
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1609
Mailing Address - Country:US
Mailing Address - Phone:787-708-6560
Mailing Address - Fax:787-708-6520
Practice Address - Street 1:AVE LAS CUMBRES
Practice Address - Street 2:STREET 199 KM 1.2
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-0000
Practice Address - Country:US
Practice Address - Phone:787-708-6560
Practice Address - Fax:787-708-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400122Medicare Oscar/Certification