1437577863 NPI number — PRE-VUE

Table of content: (NPI 1437577863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437577863 NPI number — PRE-VUE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRE-VUE
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:
1437577863
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 02 BOX 8653
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YABUCOA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00767
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-642-0775
Provider Business Mailing Address Fax Number:
180-050-7107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE PARANA 1669
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-931-7486
Provider Business Practice Location Address Fax Number:
800-507-1075
Provider Enumeration Date:
04/02/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SEPULVEDA
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
ANGEL
Authorized Official Title or Position:
PRESIDENT OF PRE-VUE CORP
Authorized Official Telephone Number:
939-642-0775

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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