1114144938 NPI number — MULTIMEDICAL SERVICES PSC

Table of content: (NPI 1114144938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114144938 NPI number — MULTIMEDICAL SERVICES PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTIMEDICAL SERVICES PSC
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:
1114144938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7438
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00726-7438
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-744-4399
Provider Business Mailing Address Fax Number:
787-744-4399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
O24 AVE L MUNOZ MARIN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-6162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-744-4399
Provider Business Practice Location Address Fax Number:
787-744-4399
Provider Enumeration Date:
04/20/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VELAZQUEZ
Authorized Official First Name:
ANGEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-744-4399

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  8516 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: 8562 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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