1790809432 NPI number — DEPARTAMENTO DE SALUD OFICIAL

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790809432 NPI number — DEPARTAMENTO DE SALUD OFICIAL

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 Other Organization Name:

OCASET

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:

1790809432

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

05/12/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

#100 URBANIZACION SANTA JUANITA

Provider Second Line Business Mailing Address:

AVENIDA 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:

Provider First Line Business Practice Location Address:

CLINICA DE INMUNOLOGIA DE ARECIBO

Provider Second Line Business Practice Location Address:

CARR 129 ANTIGUO HOSPITAL DE DISTRITO

Provider Business Practice Location Address City Name:

ARECIBO

Provider Business Practice Location Address State Name:

PR

Provider Business Practice Location Address Postal Code:

00612-3666

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

787-878-7895

Provider Business Practice Location Address Fax Number:

787-879-9026

Provider Enumeration Date:

03/19/2007

Authorized Official Last Name:

DURAN

Authorized Official First Name:

CURIDUVEL

Authorized Official Middle Name:

Authorized Official Title or Position:

DIRECTOR EXECUTIVO

Authorized Official Telephone Number:

787-945-1472

• Taxonomy code: 261QH0100X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 30346 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 660433481-12T . This is a "PEDIATRA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 7400000 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 81450 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: S082 . This is a "GENERALISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: S123 . This is a "PEDIATRA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: ========= . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 00433CPTA . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 101234 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: S110 . This is a "INTERNISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: SH10008 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 4414-1 . This is a "GENERALISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: P001 . This is a "LABORATORIO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 992357 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 4414-3 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 4417-5 . This is a "INFECTOLOGO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 660433481-12L . This is a "INTERNISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 660433481-17 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".