1407127244 NPI number — CLINICA ESPECIALIZADA INTERNACIONAL LAS TERRENAS

Table of content: DR. SHELDON DAMIAN WILLIAMS D.C. (NPI 1376723775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407127244 NPI number — CLINICA ESPECIALIZADA INTERNACIONAL LAS TERRENAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICA ESPECIALIZADA INTERNACIONAL LAS TERRENAS
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:
1407127244
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
255 ARAGON AVE, 3RD FLOOR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-931-1717
Provider Business Mailing Address Fax Number:
407-931-2121

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE DUARTE NO.26 LAS TERRENAS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAMANA
Provider Business Practice Location Address State Name:
LAS TERRENAS
Provider Business Practice Location Address Postal Code:
NONE
Provider Business Practice Location Address Country Code:
DO
Provider Business Practice Location Address Telephone Number:
407-931-1717
Provider Business Practice Location Address Fax Number:
407-931-2121
Provider Enumeration Date:
01/25/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MENA
Authorized Official First Name:
ALBERTO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
BILLING DIRECTOR
Authorized Official Telephone Number:
407-931-1717

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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