1306098686 NPI number — SECCION A NINOS CON NECESIDADES ESPECIALES

Table of content: (NPI 1306098686)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306098686 NPI number — SECCION A NINOS CON NECESIDADES ESPECIALES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SECCION A NINOS CON NECESIDADES ESPECIALES
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:
CENTRO PEDIATRICO DE PONCE
Provider Other Organization Name Type Code:
5
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:
1306098686
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
AVENIDA TITO CASTRO 931 CARR. 14 BO. MACHUELO
Provider Second Line Business Mailing Address:
CENTRO PEDIATRICO DE PONCE
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-842-5884
Provider Business Mailing Address Fax Number:
787-842-5802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CENTRO PEDIATRICO PONCE 931 CARR 14
Provider Second Line Business Practice Location Address:
BO MACHUELO AVENIDA TITO CASTRO
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00716-4717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-842-5884
Provider Business Practice Location Address Fax Number:
787-842-5802
Provider Enumeration Date:
10/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
DIRECTORA EJECUTIVA
Authorized Official Telephone Number:
787-771-2100

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: S027 . This is a "AUDIOLOGIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 433CPP . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-4G . This is a "GENETICISTA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 88754 . This is a "MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: S013 . This is a "PEDIATRA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2116-5 . This is a "ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660433481-4P . This is a "OFTALMOLOGIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 53438 . This is a "SERVICIOS ALIADOS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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