1013299015 NPI number — RECINTO DE CIENCIAS MEDICAS

Table of content: (NPI 1013299015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013299015 NPI number — RECINTO DE CIENCIAS MEDICAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RECINTO DE CIENCIAS MEDICAS
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:
RECINTO DE CIENCIAS MEDICAS (CENTRO DE CIRUGIA AMBULATORIA RCM)
Provider Other Organization Name Type Code:
3
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:
1013299015
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29134
Provider Second Line Business Mailing Address:
CENTRO DE CIRUGIA AMBULATORIA
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00929-0134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-758-7910
Provider Business Mailing Address Fax Number:
787-625-1966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CLINICA DE LA ESCUELA DE MEDICINA
Provider Second Line Business Practice Location Address:
SHOPPING REPARTO METROPOLITANO, AVE. AMERICO MIRANDA
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-7910
Provider Business Practice Location Address Fax Number:
787-625-1966
Provider Enumeration Date:
09/15/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
SHAYRA
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
ADMINISTRATIVE SECRETARY
Authorized Official Telephone Number:
787-754-9165

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA1903X , with the licence number: 11 , 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)

  • Identifier: 142 . This is a "PPMI GROPU" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".