1306036272 NPI number — DRA HILDA RIVERA QUINONES

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 1306036272 NPI number — DRA HILDA RIVERA QUINONES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRA HILDA RIVERA QUINONES
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:
1306036272
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CC16 CALLE G
Provider Second Line Business Mailing Address:
URB SANTA ELENA
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00957-1742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-725-6356
Provider Business Mailing Address Fax Number:
787-724-3527

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 CALLE WASHINGTON
Provider Second Line Business Practice Location Address:
ASHFORD MEDICAL CENTER SUITE 604
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-725-6356
Provider Business Practice Location Address Fax Number:
787-724-3527
Provider Enumeration Date:
07/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RIVERA QUINONES
Authorized Official First Name:
HILDA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-725-6356

Provider Taxonomy Codes

  • Taxonomy code: 261QX0200X , with the licence number:  12855 , 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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