1134374036 NPI number — CORPORACION DE SERVICIOS DE SALUD Y MEDICINA AVANZADA (COSSMA)

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 1134374036 NPI number — CORPORACION DE SERVICIOS DE SALUD Y MEDICINA AVANZADA (COSSMA)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORPORACION DE SERVICIOS DE SALUD Y MEDICINA AVANZADA (COSSMA)
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:
COSSMA
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:
1134374036
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1330
Provider Second Line Business Mailing Address:
AVE. EL JIBARO CARR. 172 KM. 13.5
Provider Business Mailing Address City Name:
CIDRA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00739-1330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-739-8182
Provider Business Mailing Address Fax Number:
787-739-8190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE. EL JIBARO KM. 13.5
Provider Second Line Business Practice Location Address:
CARR. 172
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-739-8182
Provider Business Practice Location Address Fax Number:
787-739-8190
Provider Enumeration Date:
11/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MIRANDA
Authorized Official First Name:
ISOLINA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTOVE DIRECTOR
Authorized Official Telephone Number:
787-739-8182

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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