1215061148 NPI number — DEPARTAMENTO DE SALUD OFICIAL

Table of content: (NPI 1215061148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215061148 NPI number — DEPARTAMENTO DE SALUD OFICIAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEPARTAMENTO DE SALUD OFICIAL
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:
CPTET-MAYAGUEZ
Provider Other Organization Name Type Code:
5
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:
1215061148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 193044
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JAUN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00919-3044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-945-1472
Provider Business Mailing Address Fax Number:
787-250-9265

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PREDIOS CENTRO MEDICO MAYAGUEZ
Provider Second Line Business Practice Location Address:
410 AVE HOSTOS CARR. # 22
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00682-1522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-834-2110
Provider Business Practice Location Address Fax Number:
787-832-6015
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DURAN
Authorized Official First Name:
CUIDUVEL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR EJECUTIVO
Authorized Official Telephone Number:
787-945-1472

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , 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: 660433481-17 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-7M . This is a "NEUMOLOGIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S005 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-7I . This is a "INFECTOLOGIA PEDIATRICA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 051756 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 065113 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-7H . This is a "INFECTOLOGO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S852 . This is a "INFECTOLOGO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40175 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S853 . This is a "INFECTOLOGO PEDIATRICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 00433 CPTM . This is a "MEDICO Y LABOARATORIO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30346 . This is a "LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3406 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6800185 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S854 . This is a "NEUMOLOGO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 234048 . This is a "MEDICO Y LAB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 81451 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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