1013289842 NPI number — INNOVATIVE ORTHO SOLUTIONS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013289842 NPI number — INNOVATIVE ORTHO SOLUTIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INNOVATIVE ORTHO SOLUTIONS 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:
1013289842
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6235
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00726-6235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-745-4201
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CRISTAL 25
Provider Second Line Business Practice Location Address:
PASEO SANTA BARBARA
Provider Business Practice Location Address City Name:
GURABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-919-2111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
PADILLA
Authorized Official First Name:
BENITO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-919-2111

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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