1265862999 NPI number — ADVANCED ELECTROPHYSIOLOGY SERVICES LLC

Table of content: (NPI 1265862999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265862999 NPI number — ADVANCED ELECTROPHYSIOLOGY SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ELECTROPHYSIOLOGY SERVICES LLC
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:
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NPI Number Information

NPI Number:
1265862999
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 METRO MEDICAL CENTER A
Provider Second Line Business Mailing Address:
995 CARRETERA NUM. 2
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 METRO MEDICAL CENTER A
Provider Second Line Business Practice Location Address:
995 CARRETERA NUM 2
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-294-9039
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARZOLA CASTANER
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE MEMBER
Authorized Official Telephone Number:
787-504-8868

Provider Taxonomy Codes

  • Taxonomy code: 207RC0001X , with the licence number:  14185 , 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: 1548278187 . This is a "INDIVIDUAL NPI" identifier . This identifiers is of the category "OTHER".