1265623326 NPI number — HEALTH CARE FAMILY MANAGEMENT P.S.C.

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 1265623326 NPI number — HEALTH CARE FAMILY MANAGEMENT P.S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH CARE FAMILY MANAGEMENT P.S.C.
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:
6
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:
1265623326
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
238 CALLE ALMENDRO
Provider Second Line Business Mailing Address:
GRAND PALM II
Provider Business Mailing Address City Name:
VEGA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00692-2440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-915-5274
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
238 CALLE ALMENDRO
Provider Second Line Business Practice Location Address:
GRAND PALM II
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692-2440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-915-5274
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VAZQUEZ
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
MORALES
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
787-915-5274

Provider Taxonomy Codes

  • Taxonomy code: 302F00000X , with the licence number:  15082 , 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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