1588637789 NPI number — AGUADILLA MEDICAL SERVICES, INC.

Table of content: (NPI 1588637789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588637789 NPI number — AGUADILLA MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AGUADILLA MEDICAL SERVICES, INC.
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:
1588637789
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 250479
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00604-0479
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-882-0303
Provider Business Mailing Address Fax Number:
787-997-1680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 AVE VICTORIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603-4728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-882-0303
Provider Business Practice Location Address Fax Number:
787-997-1680
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
BETHZAIDA
Authorized Official Middle Name:
Authorized Official Title or Position:
SUPERVISOR
Authorized Official Telephone Number:
787-882-0303

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  22 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QA1903X , with the licence number: 1 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QE0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 864 , 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)

  • Identifier: 4000404 . This is a "EMERGENCY ROOM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 5501113 . This is a "ANESTHESIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 73-314 . This is a "EMERGENCY ROOM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3732-4 . This is a "X RAY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6005853 . This is a "LABORATORY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3732-2 . This is a "EMERGENCY ROOM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3732-3 . This is a "LABORATORY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 5501121 . This is a "GENERAL ANESTHESIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 0120073 . This is a "MEDICAL SERVICES" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 030227 . This is a "EMERGENCY ROOM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40001 . This is a "MEDICAL SERVICES" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3005054 . This is a "X RAY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3732-5 . This is a "PROCEDURES" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 56-324 . This is a "X RAY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 74-313 . This is a "LABORATORY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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