Provider Demographics
NPI:1992917314
Name:HEMA ONCO DE ARECIBO INC
Entity type:Organization
Organization Name:HEMA ONCO DE ARECIBO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-817-4973
Mailing Address - Street 1:425 CARR 693 PMB 371
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4802
Mailing Address - Country:US
Mailing Address - Phone:787-817-4973
Mailing Address - Fax:
Practice Address - Street 1:53 CALLE ANDRES GARCIA
Practice Address - Street 2:URB GARCIA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4335
Practice Address - Country:US
Practice Address - Phone:787-817-4973
Practice Address - Fax:787-817-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-06
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085058Medicare ID - Type UnspecifiedPROVIDER NUMBER