Provider Demographics
NPI:1922337146
Name:HOSPICIO SAN MIGUEL, INC.
Entity Type:Organization
Organization Name:HOSPICIO SAN MIGUEL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-692-2457
Mailing Address - Street 1:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0688
Mailing Address - Country:US
Mailing Address - Phone:787-851-2962
Mailing Address - Fax:787-851-2962
Practice Address - Street 1:PLAZA ALONSO BO. MIRADERO CARR. PR-311 KM 3.2
Practice Address - Street 2:INTERSECCION CARR. PR-100
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-851-2962
Practice Address - Fax:787-851-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11-B-4687315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient