Provider Demographics
NPI:1144362807
Name:HOSTOS MEDICAL SERVICES INC
Entity type:Organization
Organization Name:HOSTOS MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:PALMER MELLOWES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-215-6056
Mailing Address - Street 1:PO BOX 1586
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1586
Mailing Address - Country:US
Mailing Address - Phone:787-265-3320
Mailing Address - Fax:787-265-2929
Practice Address - Street 1:28 CALLE DE DIEGO W
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4736
Practice Address - Country:US
Practice Address - Phone:787-265-3320
Practice Address - Fax:787-265-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization