Provider Demographics
NPI:1184778375
Name:INMOBILIARIA SAN ALBERTO INC.
Entity type:Organization
Organization Name:INMOBILIARIA SAN ALBERTO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-854-3322
Mailing Address - Street 1:PO BOX 30532
Mailing Address - Street 2:P.O BOX 30532
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-8513
Mailing Address - Country:US
Mailing Address - Phone:787-854-3322
Mailing Address - Fax:787-884-0178
Practice Address - Street 1:ROAD #2 KM 47.7
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-8513
Practice Address - Country:US
Practice Address - Phone:787-854-3322
Practice Address - Fax:787-884-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR47282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400118Medicare ID - Type UnspecifiedPROVIDER NUMBER OF MEDICA