Provider Demographics
NPI:1992091425
Name:MUNICIPIO DE GUAYANILLA
Entity type:Organization
Organization Name:MUNICIPIO DE GUAYANILLA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:N
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-835-5366
Mailing Address - Street 1:PO BOX 560550
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-0550
Mailing Address - Country:US
Mailing Address - Phone:787-835-5366
Mailing Address - Fax:787-835-5366
Practice Address - Street 1:13 CALLE JOSE DE DIEGO
Practice Address - Street 2:
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656-1830
Practice Address - Country:US
Practice Address - Phone:787-835-5366
Practice Address - Fax:787-835-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR71261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care