1235258872 NPI number — LABORATORIO CARDIOVASCULAR MUNOZ MARIN

Table of content: (NPI 1235258872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235258872 NPI number — LABORATORIO CARDIOVASCULAR MUNOZ MARIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CARDIOVASCULAR MUNOZ MARIN
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:
1235258872
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:
1446 AMERICO SALAS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTURCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-726-4196
Provider Business Mailing Address Fax Number:
787-722-7403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1446 AMERICO SALAS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-726-4196
Provider Business Practice Location Address Fax Number:
787-722-7403
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MUNOZ
Authorized Official First Name:
ROBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
CARDIOLOGY
Authorized Official Telephone Number:
787-726-4196

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X , with the licence number:  5829 , 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: 220262 . This is a "PREFERED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 66961 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2883 . This is a "PREFERED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 97384MU . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: N596 . This is a "FIRST MEDICAL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8000429 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 65657 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: SE3393 . This is a "PALIC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 600063 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com