1316284409 NPI number — JIMENEZ-HUYKE MEDICAL OFFICES, M.D. , L.L.C.

Table of content: (NPI 1316284409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316284409 NPI number — JIMENEZ-HUYKE MEDICAL OFFICES, M.D. , L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JIMENEZ-HUYKE MEDICAL OFFICES, M.D. , L.L.C.
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:
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:
1316284409
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 CALLE LANZALOTE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00727-1402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-283-0804
Provider Business Mailing Address Fax Number:
787-761-5764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 AVE FONT MARTELO
Provider Second Line Business Practice Location Address:
SUITE 409
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791-3249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-283-0804
Provider Business Practice Location Address Fax Number:
787-761-5764
Provider Enumeration Date:
01/09/2013

Additional Information

Authorized Official

Authorized Official Last Name:
JIMENEZ-HUYKE
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-283-0804

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  14798 , 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)

  • Identifier: 14798 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com