1225254287 NPI number — SECCION A NINOS CON NECESIDADES ESPECIALES

Table of content: (NPI 1225254287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225254287 NPI number — SECCION A NINOS CON NECESIDADES ESPECIALES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SECCION A NINOS CON NECESIDADES ESPECIALES
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:
CENTRO PEDIATRICO DE FAJARDO
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:
1225254287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CENTRO PEDIATRICO DE FAJARDO
Provider Second Line Business Mailing Address:
CALLE E SUITE 77 URB MONTEBRISAS
Provider Business Mailing Address City Name:
FAJARDO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-704-7066
Provider Business Mailing Address Fax Number:
787-746-2898

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CENTRO PEDIATRICO DE FAJARDO
Provider Second Line Business Practice Location Address:
CALLE E SUITE 77 URB MONTEBRISAS
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-704-7066
Provider Business Practice Location Address Fax Number:
787-746-2898
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
DIRETOR EJECUTIVO
Authorized Official Telephone Number:
787-771-2100

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: 600324 . This is a "MEDICOS Y ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7174 . This is a "MEDICOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 53212 . This is a "ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481 - 0026 . This is a "MEDICS Y ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7380038 . This is a "MEDICO Y ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 88737 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2424-5 . This is a "MEDICOS Y ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-3 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 060522 . This is a "MEDICOS Y ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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