1043227333 NPI number — DR. JOSE RAFAEL PEREZ -QUIROS M.D.

Table of content: DR. JOSE RAFAEL PEREZ -QUIROS M.D. (NPI 1043227333)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043227333 NPI number — DR. JOSE RAFAEL PEREZ -QUIROS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ -QUIROS
Provider First Name:
JOSE
Provider Middle Name:
RAFAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1043227333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
74 CALLE REINA ALEXANDRA
Provider Second Line Business Mailing Address:
URB. LA VILLA DE TORRIMAR
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-3273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-731-8941
Provider Business Mailing Address Fax Number:
787-731-8941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
52 CALLE MAYAGUEZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HATO REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917-4915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-764-0273
Provider Business Practice Location Address Fax Number:
787-764-0273
Provider Enumeration Date:
08/01/2006

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: 208600000X , with the licence number:  8725 , 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: 067858 . This is a "LA CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8000312 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 686 . This is a "AMERICAN HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 82110PE . This is a "TRIPLE S, INC." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 204106 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 82110PE . This is a "TRIPLE S, INC. REFORMA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 82110PE . This is a "MEDICARE OPTIMA SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7983 . This is a "FIRST MEDICAL IMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com