1295265189 NPI number — MISS JOSYMAR OLIVIERI BSN

Table of content: MISS JOSYMAR OLIVIERI BSN (NPI 1295265189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295265189 NPI number — MISS JOSYMAR OLIVIERI BSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLIVIERI
Provider First Name:
JOSYMAR
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
BSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OLIVIERI
Provider Other First Name:
JOSYMAR
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295265189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 515
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIEQUES
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00765-0515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-981-3778
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
171 CALLE 65 INFANTERIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VIEQUES
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-616-5225
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  083361 , 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)