Provider Demographics
NPI:1841270659
Name:HATO REY ORTHOPEDIC ASSOC
Entity type:Organization
Organization Name:HATO REY ORTHOPEDIC ASSOC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-250-7676
Mailing Address - Street 1:400 AVE FD ROOSEVELT
Mailing Address - Street 2:SUITE 406
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2103
Mailing Address - Country:US
Mailing Address - Phone:787-250-7676
Mailing Address - Fax:787-756-5210
Practice Address - Street 1:400 F D ROOSEVELT AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-250-7676
Practice Address - Fax:787-756-5210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR26161Medicare ID - Type Unspecified