1427450659 NPI number — JORGE VARELA DENTAL OFFICE

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 1427450659 NPI number — JORGE VARELA DENTAL OFFICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JORGE VARELA DENTAL OFFICE
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:
1427450659
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 TORRE DE PLAZA LAS AMERICAS FDR
Provider Second Line Business Mailing Address:
SUITE 609
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00918-8001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-763-5503
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 AVE FRANKLIN D ROOSEVELT
Provider Second Line Business Practice Location Address:
SUITE 609 TORRE PLAZA LAS AMERICAS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-8001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-763-5503
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/18/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VARELA
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-763-5503

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  2329 , 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)