1285497339 NPI number — ORTHOPEDIC AND SPINE CENTER OF PUERTO RICO LLC

Table of content: HRATCH NERSES SVADJIAN M.D. (NPI 1720178254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285497339 NPI number — ORTHOPEDIC AND SPINE CENTER OF PUERTO RICO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC AND SPINE CENTER OF PUERTO RICO 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:
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:
1285497339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2225 PONCE BY PASS
Provider Second Line Business Mailing Address:
PARRA MEDICAL PLAZA 1003 1004
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-492-0014
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL DAMAS
Provider Second Line Business Practice Location Address:
2225 PONCE BYPASS PARRA MEDICAL PLAZA SUITE 1003-1004
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717-1313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-492-0014
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MANGUAL PEREZ
Authorized Official First Name:
DANNY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-340-0913

Provider Taxonomy Codes

  • Taxonomy code: 207XP3100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0114X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0117X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)