1801232004 NPI number — MARIA PALOU PHYSIATRIC SERVICES, PSC

Table of content: (NPI 1801232004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801232004 NPI number — MARIA PALOU PHYSIATRIC SERVICES, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARIA PALOU PHYSIATRIC SERVICES, PSC
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:
1801232004
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
# 2 MANUEL GARCIA BAJOS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS PIEDRAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00771-3063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-733-1222
Provider Business Mailing Address Fax Number:
787-733-1310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
# 2 MANUEL GARCIA BAJOS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00771-3063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-733-1222
Provider Business Practice Location Address Fax Number:
787-733-1310
Provider Enumeration Date:
05/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
PALOU-AVILES
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
INES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-733-1222

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  11325 , 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)





Copyright © 2007-2024 www.npivalidator.com