Provider Demographics
NPI:1932171790
Name:MUNICIPIO DE MAUNABO
Entity Type:Organization
Organization Name:MUNICIPIO DE MAUNABO
Other - Org Name:CDS MAUNABO
Other - Org Type:Other Name
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARQUEZ PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-861-0810
Mailing Address - Street 1:AVENIDA KENNEDY
Mailing Address - Street 2:APORTADO 8
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707
Mailing Address - Country:US
Mailing Address - Phone:787-861-1407
Mailing Address - Fax:787-861-1407
Practice Address - Street 1:AVENIDA KENNEDY
Practice Address - Street 2:APORTADO 8
Practice Address - City:MAUNABO
Practice Address - State:PR
Practice Address - Zip Code:00707
Practice Address - Country:US
Practice Address - Phone:787-861-1407
Practice Address - Fax:787-861-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR50282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
0085061Medicare ID - Type Unspecified