Provider Demographics
NPI:1376353797
Name:HOSPITEN VALLARTA
Entity type:Organization
Organization Name:HOSPITEN VALLARTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA TORRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-526-9751
Mailing Address - Street 1:PO BOX 39662
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339-9662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BLVD FCO. MEDINA ASCENCIO # 3970 COL. VILLA LAS FLORES
Practice Address - Street 2:
Practice Address - City:PUERTO VALLARTA
Practice Address - State:JALISCO
Practice Address - Zip Code:48335
Practice Address - Country:MX
Practice Address - Phone:322-226-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access