1992031462 NPI number — MRS. NITZA CAMACHO CARATTINI M.A.C.

Table of content: MRS. NITZA CAMACHO CARATTINI M.A.C. (NPI 1992031462)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992031462 NPI number — MRS. NITZA CAMACHO CARATTINI M.A.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARATTINI
Provider First Name:
NITZA
Provider Middle Name:
CAMACHO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARATTINI
Provider Other First Name:
NITZA
Provider Other Middle Name:
CAMACHO
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992031462
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 CALLE LAUREL
Provider Second Line Business Mailing Address:
PO BOX 79
Provider Business Mailing Address City Name:
AIBONITO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00705-4128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-612-7534
Provider Business Mailing Address Fax Number:
787-735-3958

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CALLE LAUREL
Provider Second Line Business Practice Location Address:
APAT. 79
Provider Business Practice Location Address City Name:
AIBONITO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00705-4128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-612-7534
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2009

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: 101Y00000X , with the licence number:  002168 , 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)





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