1093836264 NPI number — SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.

Table of content: (NPI 1093836264)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093836264 NPI number — SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.
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:
SIRO INC
Provider Other Organization Name Type Code:
5
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:
1093836264
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1302
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HORMIGUEROS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00660-5302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-849-2179
Provider Business Mailing Address Fax Number:
787-849-2205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
L10 CALLE 4
Provider Second Line Business Practice Location Address:
COLINAS DEL OESTE
Provider Business Practice Location Address City Name:
HORMIGUEROS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00660-1939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-849-2179
Provider Business Practice Location Address Fax Number:
787-849-2205
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
DAISY
Authorized Official Middle Name:
Authorized Official Title or Position:
CORPORATE DIRECTOR
Authorized Official Telephone Number:
787-849-2179

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  6 , 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: 99-0037-3 . This is a "ACAA-SNF" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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