Organization
BELLA VISTA HOSPITAL INC
Active
Parent organization
BELLA VISTA HOSPITAL INC
Other names
Bella Vista Physical & Sports Rehab Team
Organization subpart
Yes
Provider details
NPI number
Legal business name
BELLA VISTA HOSPITAL INC
Authorized official
MR. JOSE GUILLERMO GRATACOS CFO (CHIEF FINANCIAL OFFICER)
(787) 834-2350
Entity
Organization
Contact information
Practice address
349 ST. KM 3.4, MAYAGUEZ, PR 00680-0000
(787) 834-6000
(787) 805-3705
Mailing address
PO BOX 1750, MAYAGUEZ, PR 00681-1750
(787) 834-6000
(787) 805-3705
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400014
MEDICARE ID
PR
Enumeration date
09/15/2014
Last updated
09/15/2014
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