1467546572 NPI number — GOBIERNO MUNICIPAL DE CIDRA

Table of content: (NPI 1467546572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467546572 NPI number — GOBIERNO MUNICIPAL DE CIDRA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOBIERNO MUNICIPAL DE CIDRA
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:
1467546572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
APARTADO 729
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CIDRA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00739-0729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-739-2395
Provider Business Mailing Address Fax Number:
787-369-7990

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SALIDA HOIA AGUAS BUENAS
Provider Second Line Business Practice Location Address:
COMPLEJO DEPORTIUO
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739-0729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-739-2375
Provider Business Practice Location Address Fax Number:
787-369-7990
Provider Enumeration Date:
10/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REYES
Authorized Official First Name:
ADALBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-434-1400

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: TC-AMB-223 , 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)