1154309169 NPI number — INSTITUTO MEDICO DEL NORTE INC

Table of content: (NPI 1154309169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154309169 NPI number — INSTITUTO MEDICO DEL NORTE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTO MEDICO DEL NORTE 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:
CENTRO MEDICO WILMA N VAZQUEZ
Provider Other Organization Name Type Code:
3
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:
1154309169
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALL BOX 7001
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VEGA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00694-7001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-858-1580
Provider Business Mailing Address Fax Number:
787-858-2385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 2 KM 39 5 BO ALGARROBO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VEGA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-858-1580
Provider Business Practice Location Address Fax Number:
787-858-2385
Provider Enumeration Date:
01/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
APONTE
Authorized Official First Name:
MIGUEL
Authorized Official Middle Name:
Authorized Official Title or Position:
IT MANAGER
Authorized Official Telephone Number:
787-858-1580

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  69 , 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)





Copyright © 2007-2024 www.npivalidator.com