Provider Demographics
NPI:1093848285
Name:SOCIEDAD PRO HOSPITAL DEL NINO
Entity type:Organization
Organization Name:SOCIEDAD PRO HOSPITAL DEL NINO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-783-2226
Mailing Address - Street 1:PO BOX 2124
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-2124
Mailing Address - Country:US
Mailing Address - Phone:787-783-2226
Mailing Address - Fax:787-783-2226
Practice Address - Street 1:CARR 1490 KM 0.6 MONACILLO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-783-2226
Practice Address - Fax:787-783-1325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherTAX NUMBER