1558401877 NPI number — DR. IVAN GARCIA CUEVAS MD

Table of content: DR. IVAN GARCIA CUEVAS MD (NPI 1558401877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558401877 NPI number — DR. IVAN GARCIA CUEVAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUEVAS
Provider First Name:
IVAN
Provider Middle Name:
GARCIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1558401877
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VILLAS DE LA PLAYA LUQUILLO 382
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VEGA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00693-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-403-4135
Provider Business Mailing Address Fax Number:
787-815-3465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO MORAFLORES
Provider Second Line Business Practice Location Address:
CARR 638 KM 6
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-815-3465
Provider Business Practice Location Address Fax Number:
787-815-3465
Provider Enumeration Date:
02/07/2007

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: 208D00000X , with the licence number:  13864 , 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: 100157 . This is a "MMM HEALTHCARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 897097836 . This is a "MCS INSURANCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4263 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 21961 . This is a "TRIPLE S OF PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6590076 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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