Provider Demographics
NPI:1962650531
Name:HOSPITAL SANTA ROSA
Entity Type:Organization
Organization Name:HOSPITAL SANTA ROSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ VILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-864-0101
Mailing Address - Street 1:P O BOX 10008
Mailing Address - Street 2:AVE LOS VETERANOS
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785
Mailing Address - Country:US
Mailing Address - Phone:787-864-0101
Mailing Address - Fax:787-866-0489
Practice Address - Street 1:AVE LOS VETERANOS
Practice Address - Street 2:CARR NO 3 SALIDA HACIA ARROYO
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:UM
Practice Address - Phone:787-864-0101
Practice Address - Fax:787-866-0489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR39282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========Medicare Oscar/Certification