# HATO REY MEDICAL GASTRO,CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316942956
- **Authorized official:** MR. JOSE C JIMENEZ MD (PRESIDENT)
- **Authorized official phone:** (787) 274-1282

## Contact information

- **Practice address:** 735 AVE PONCE DE LEON STE 809, TORRE MEDICA AUXILIO MUTUO, SAN JUAN, PR 00917-5031
- **Practice address phone:** (787) 274-1282
- **Practice address fax:** (787) 764-0898
- **Mailing address:** 735 AVE PONCE DE LEON STE 809, TORRE MEDICA AUXILIO MUTUO, SAN JUAN, PR 00917-5031
- **Mailing address phone:** (787) 274-1282
- **Mailing address fax:** (787) 764-0898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 12594 | PR | — |
| 207RG0100X | Gastroenterology Physician | 15480 | PR | — |
| 207RG0100X | Gastroenterology Physician | 7165 | PR | Yes |

## Other

- **Enumeration date:** 06/20/2005
- **Last updated:** 07/09/2012