1053796193 NPI number — RECINTO DE CIENCIAS MEDICAS

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 1053796193 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:
Provider Other Organization Name Type Code:
6
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:
1053796193
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29207
Provider Second Line Business Mailing Address:
GERIATRIA HUPR
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00929-0207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-757-6420
Provider Business Mailing Address Fax Number:
787-757-0520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 3 KM 8.3 AVE 65 DE INFANTERIA
Provider Second Line Business Practice Location Address:
HOSPITAL DE LA UPR DR. FEDERICO TRILLA
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00984
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-757-1800
Provider Business Practice Location Address Fax Number:
787-757-0520
Provider Enumeration Date:
07/29/2015

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: 207RG0300X , 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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