Provider Demographics
NPI:1972818599
Name:HOSPITAL EPISCOPAL SAN LUCAS PONCE
Entity Type:Organization
Organization Name:HOSPITAL EPISCOPAL SAN LUCAS PONCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:VAZQUEZ-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP,FACP
Authorized Official - Phone:787-844-2080
Mailing Address - Street 1:26 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-2201
Mailing Address - Country:US
Mailing Address - Phone:787-414-7782
Mailing Address - Fax:787-844-1271
Practice Address - Street 1:917 AVE TITO CASTRO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4717
Practice Address - Country:US
Practice Address - Phone:787-844-2080
Practice Address - Fax:787-844-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28134282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital