1093042764 NPI number — FRANCISCO RAFAEL ARRIETA PONTE DC

Table of content: FRANCISCO RAFAEL ARRIETA PONTE DC (NPI 1093042764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093042764 NPI number — FRANCISCO RAFAEL ARRIETA PONTE DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARRIETA PONTE
Provider First Name:
FRANCISCO
Provider Middle Name:
RAFAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

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:
1093042764
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10-23 CALLE 3
Provider Second Line Business Mailing Address:
URBANIZACION SANTA ROSA
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959-6612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-244-4671
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
J13 CALLE 2
Provider Second Line Business Practice Location Address:
EXTENSION HERMANAS DAVILA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-5068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-294-5793
Provider Business Practice Location Address Fax Number:
787-294-5792
Provider Enumeration Date:
11/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  466 , 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)





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