1467422162 NPI number — DR. HECTOR J STELLA ESTEVEZ MD

Table of content: DR. HECTOR J STELLA ESTEVEZ MD (NPI 1467422162)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467422162 NPI number — DR. HECTOR J STELLA ESTEVEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STELLA ESTEVEZ
Provider First Name:
HECTOR
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1467422162
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1353 AVE LUIS VIGOREAUX
Provider Second Line Business Mailing Address:
PMB 671
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00966-2715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-707-0020
Provider Business Mailing Address Fax Number:
787-782-2056

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 CALLE ALDEBARAN
Provider Second Line Business Practice Location Address:
URB ALTAMIRA
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-707-0020
Provider Business Practice Location Address Fax Number:
787-782-2056
Provider Enumeration Date:
01/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  10812 , 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)