# HOSPITAL ANDRES GRILLASCA,INC,

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

## Provider details

- **NPI number:** 1619193539
- **Authorized official:** MR. MANUEL J VAZQUEZ MHSA (EXCUTIVE DIRECTOR)
- **Authorized official phone:** (787) 848-0800

## Contact information

- **Practice address:** TITO CASTRO AVE.CARR. 14 BO. MACHUELO, PONCE, PR 00733-1324
- **Practice address phone:** (787) 848-0800
- **Practice address fax:** (787) 843-2310
- **Mailing address:** PO BOX 331324, PONCE, PR 00733-1324
- **Mailing address phone:** (787) 848-0800
- **Mailing address fax:** (787) 843-2310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 12 | PR | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 12 | PR | Yes |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 06/28/2011