1407978307 NPI number — DEPARTAMENTO DE SALUD OFICIAL

Table of content: (NPI 1407978307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407978307 NPI number — DEPARTAMENTO DE SALUD OFICIAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEPARTAMENTO DE SALUD OFICIAL
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:
CPTET FAJARDO
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:
1407978307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
#100 URBANIZACION SANTA JUANITA
Provider Second Line Business Mailing Address:
AVE LAUREL
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00956-4816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-765-2929
Provider Business Mailing Address Fax Number:
787-863-5437

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL HIMMA SAN PABLO
Provider Second Line Business Practice Location Address:
EDIFICIO CLINICAS EXTERNAS, SEGUNDO PISO
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-765-2929
Provider Business Practice Location Address Fax Number:
787-863-5437
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DURAN
Authorized Official First Name:
CUIDUVEL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR EJECUTIVO
Authorized Official Telephone Number:
787-765-2929

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , 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: 4547-1 . This is a "MEDICOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-11L . This is a "INTERNISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 81459 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S008 . This is a "LABORATORIO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S078 . This is a "INFECTOLOGO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 004333CPTC . This is a "MED Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4547-3 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 600248 . This is a "MED Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7400004 . This is a "MED Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30346 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 101238 . This is a "MED Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4547-5 . This is a "ESPECIALISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-11T . This is a "PEDIATRA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S929 . This is a "INTERNISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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