1316048119 NPI number — DR. AMARYLLIS AYMAT-RODRIGUEZ MD

Table of content: DR. AMARYLLIS AYMAT-RODRIGUEZ MD (NPI 1316048119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316048119 NPI number — DR. AMARYLLIS AYMAT-RODRIGUEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AYMAT-RODRIGUEZ
Provider First Name:
AMARYLLIS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316048119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PLAZA 12 D-9
Provider Second Line Business Mailing Address:
CAMBRIDGE PARK
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-1450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-764-6477
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 159 0.9 DESVIO DE COROZAL
Provider Second Line Business Practice Location Address:
BARRIO ABRA
Provider Business Practice Location Address City Name:
COROZAL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00783-9750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-859-2560
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2006

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: 208000000X , with the licence number:  7730 , 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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