1215053996 NPI number — INSTITUTO DE MEDICINA PRIMARIA Y URGENCIAS DEL SUR CSP

Table of content: (NPI 1215053996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215053996 NPI number — INSTITUTO DE MEDICINA PRIMARIA Y URGENCIAS DEL SUR CSP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTO DE MEDICINA PRIMARIA Y URGENCIAS DEL SUR CSP
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:
INSTITUTO DE MEDICINA PRIMARIA Y URGENCIAS DEL SUR CSP
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:
1215053996
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CARR. 132 KM 18.2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENUELAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-284-0603
Provider Business Mailing Address Fax Number:
787-812-5544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE MARINA 9105 ESQ FERROCARRIL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-812-5522
Provider Business Practice Location Address Fax Number:
787-812-5544
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ORENGO SOLER
Authorized Official First Name:
HILDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENTA
Authorized Official Telephone Number:
787-812-5522

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4277 . This is a "REGISTRO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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