Provider Demographics
NPI:1124170261
Name:HOSPITAL UNIVERSITARIO DE ADULTOS
Entity type:Organization
Organization Name:HOSPITAL UNIVERSITARIO DE ADULTOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA FACTURACION Y COBRO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-754-0101
Mailing Address - Street 1:PO BOX 2116
Mailing Address - Street 2:CENTRO MEDICO DE PUERTO RICO CENTRO RENAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-2116
Mailing Address - Country:US
Mailing Address - Phone:787-754-0101
Mailing Address - Fax:787-763-3684
Practice Address - Street 1:MONACILLO ST. 2116
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO CENTRO RENAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-2116
Practice Address - Country:US
Practice Address - Phone:787-754-0101
Practice Address - Fax:787-763-3684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========Medicare ID - Type UnspecifiedCENTRO RENAL