1164618773 NPI number — RICARDO DE ARMAS PALOMERA MD PA

Table of content: JOSE EDUARDO FOSSAS ESPINOSA (NPI 1831650704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164618773 NPI number — RICARDO DE ARMAS PALOMERA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICARDO DE ARMAS PALOMERA MD PA
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:
1164618773
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4201 PALM AVE #2BB
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-822-7980
Provider Business Mailing Address Fax Number:
305-822-8036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4201 PALM AVE #2BB
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-822-7980
Provider Business Practice Location Address Fax Number:
305-822-8036
Provider Enumeration Date:
09/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DE ARMAS PALOMERA
Authorized Official First Name:
RICARDO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
305-822-7980

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  ME90129 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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