Provider Demographics
NPI:1871164871
Name:HOSPITAL MENONITA CAGUAS INC
Entity type:Organization
Organization Name:HOSPITAL MENONITA CAGUAS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR BILLING AND COLLECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-434-1700
Mailing Address - Street 1:PO BOX 1650
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1650
Mailing Address - Country:US
Mailing Address - Phone:787-434-1700
Mailing Address - Fax:787-434-1711
Practice Address - Street 1:URB TURABO GARDENS SALIDA CARRETERA 172
Practice Address - Street 2:SALIDA 21 CAGUAS A CIDRA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-8888
Practice Address - Country:US
Practice Address - Phone:787-434-1700
Practice Address - Fax:787-434-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7OtherDEPARTAMENTO DE SALUD DE PUERTO RICO