1245583129 NPI number — CENTRO TERAPEUTICO DE SAN JUAN

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 1245583129 NPI number — CENTRO TERAPEUTICO DE SAN JUAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO TERAPEUTICO DE SAN JUAN
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:
1245583129
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WISTON CHURCHILL AVE. 138
Provider Second Line Business Mailing Address:
SUITE 707
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-292-0903
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB. LAS ROSAS
Provider Second Line Business Practice Location Address:
R-5
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-292-0903
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ARROYO
Authorized Official First Name:
MARGARITA
Authorized Official Middle Name:
HURTADO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-292-0903

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  589 , 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)





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