1023434750 NPI number — DR.HIGINIO A GONZALEZ PSYD:SERVICIOS PSICOLOGICOS Y PSICOEDUCATIVOS CS

Table of content: (NPI 1023434750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023434750 NPI number — DR.HIGINIO A GONZALEZ PSYD:SERVICIOS PSICOLOGICOS Y PSICOEDUCATIVOS CS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR.HIGINIO A GONZALEZ PSYD:SERVICIOS PSICOLOGICOS Y PSICOEDUCATIVOS CS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023434750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. VILLA MILAGROS B-15
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-675-9868
Provider Business Mailing Address Fax Number:
787-259-5995

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SECTOR CUATRO CALLES SUITE # 7
Provider Second Line Business Practice Location Address:
EDIF. PROFESIONAL
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-675-9868
Provider Business Practice Location Address Fax Number:
787-259-5995
Provider Enumeration Date:
03/05/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
HIGINIO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-675-9868

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  002331 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002331 . This is a "LICENCIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 103TC0700X . This is a "PROVIDER TAXONOMIES" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".