1417656372 NPI number — ADVANCED HEMATOLOGY AND ONCOLOGY SERVICES LLC

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 1417656372 NPI number — ADVANCED HEMATOLOGY AND ONCOLOGY SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED HEMATOLOGY AND ONCOLOGY SERVICES LLC
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:
1417656372
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 CALLE JUAN C BORBON STE 67-286
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-5374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-638-2806
Provider Business Mailing Address Fax Number:
787-263-2152

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 14 KM 12 BO RICON
Provider Second Line Business Practice Location Address:
202
Provider Business Practice Location Address City Name:
CAYEY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-535-0404
Provider Business Practice Location Address Fax Number:
787-263-2152
Provider Enumeration Date:
03/01/2023

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
OMAYRA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-535-0404

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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