1013324243 NPI number — AILATI CORP.

Table of content: (NPI 1013324243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013324243 NPI number — AILATI CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AILATI CORP.
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:
AFSN-CONSULTING
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:
1013324243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 22943
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33002-2943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-867-8020
Provider Business Mailing Address Fax Number:
305-460-3288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 NW 177TH ST
Provider Second Line Business Practice Location Address:
SECOND FLOOR, # 207
Provider Business Practice Location Address City Name:
MIAMI GARDENS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33169-4954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-867-8020
Provider Business Practice Location Address Fax Number:
305-460-3288
Provider Enumeration Date:
07/21/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PUSEY
Authorized Official First Name:
JANNETT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF CORDINATING DIRECTOR
Authorized Official Telephone Number:
305-793-8650

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  730057 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X , with the licence number: 730057 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1659408243 . This is a "VETERAN HOSPITAL MIAMI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".