1053375501 NPI number — HUMBERTO HERRERA CESPEDES M.D.

Table of content: HUMBERTO HERRERA CESPEDES M.D. (NPI 1053375501)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053375501 NPI number — HUMBERTO HERRERA CESPEDES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERRERA CESPEDES
Provider First Name:
HUMBERTO
Provider Middle Name:
Provider Name Prefix Text:
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:
1053375501
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8908
Provider Second Line Business Mailing Address:
PLAZA CAROLINA STATION,
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00988-8908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-276-1743
Provider Business Mailing Address Fax Number:
787-283-1356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GP8 AVE ROBERTO SANCHEZ VILELLA
Provider Second Line Business Practice Location Address:
COUNTRY CLUB
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00982-2677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-276-1743
Provider Business Practice Location Address Fax Number:
787-283-1356
Provider Enumeration Date:
04/13/2006

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: 208D00000X , with the licence number:  10270 , 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)





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