1255455655 NPI number — ANA Y RIVERA

Table of content: (NPI 1255455655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255455655 NPI number — ANA Y RIVERA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANA Y RIVERA
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:
CLEANICA DE OJOS TRUJILLO ALTO
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:
1255455655
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1173
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT JUST
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00978-1173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-760-7650
Provider Business Mailing Address Fax Number:
787-283-6131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 848 # KM0H2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00976-3068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-760-7650
Provider Business Practice Location Address Fax Number:
787-283-6131
Provider Enumeration Date:
03/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RIVERA
Authorized Official First Name:
ANA
Authorized Official Middle Name:
Y
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-760-7650

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2545 . This is a "AMERCIAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 051955 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 00289 . This is a "GIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 00032 . This is a "VISION HERMISFERICA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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