1023950961 NPI number — PUERTO RICO PULMONARY GROUP LLC

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 1023950961 NPI number — PUERTO RICO PULMONARY GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUERTO RICO PULMONARY GROUP LLC
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:
1023950961
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
KK-7 VIA PERIFERICA
Provider Second Line Business Mailing Address:
URB. JARDINES DE CAPARRA
Provider Business Mailing Address City Name:
BATAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959-7628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-597-5945
Provider Business Mailing Address Fax Number:
787-269-3900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 EDIFICIO SANTA CRUZ STE313
Provider Second Line Business Practice Location Address:
CALLE SANTA CRUZ
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-930-4845
Provider Business Practice Location Address Fax Number:
787-537-7071
Provider Enumeration Date:
04/08/2026

Additional Information

Authorized Official

Authorized Official Last Name:
LATALLADI ORTEGA
Authorized Official First Name:
GRACIELA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-930-4845

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com