1538464730 NPI number — MRS. SILVIA SUGEY VADELL

Table of content: MRS. SILVIA SUGEY VADELL (NPI 1538464730)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538464730 NPI number — MRS. SILVIA SUGEY VADELL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VADELL
Provider First Name:
SILVIA
Provider Middle Name:
SUGEY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1538464730
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7074 GROVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKSVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34609-8658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-540-9335
Provider Business Mailing Address Fax Number:
352-544-0722

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7074 GROVE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKSVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34609-8658
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-540-9335
Provider Business Practice Location Address Fax Number:
352-544-0722
Provider Enumeration Date:
01/19/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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