1427230952 NPI number — EMILIO O VINCENTY-ASAD

Table of content: LACEY SMITH THAMES O.D. (NPI 1265729495)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427230952 NPI number — EMILIO O VINCENTY-ASAD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMILIO O VINCENTY-ASAD
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:
1427230952
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1903
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-1903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-265-5600
Provider Business Mailing Address Fax Number:
787-805-1044

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
134 CALLE DR VADI
Provider Second Line Business Practice Location Address:
BO CRISTY
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680-3732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-265-5600
Provider Business Practice Location Address Fax Number:
787-805-1044
Provider Enumeration Date:
11/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VINCENTY
Authorized Official First Name:
EMILIO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-265-5600

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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