Provider Demographics
NPI:1912348392
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:TRANSITIONAL RESIDENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
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:
Mailing Address - Fax:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital