1518008770 NPI number — DR. MAGDA ELAINE DE POOL M.D.

Table of content: BRAD WASHINGTON (NPI 1427417922)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518008770 NPI number — DR. MAGDA ELAINE DE POOL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DE POOL
Provider First Name:
MAGDA ELAINE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DE POOL FIGUEROA
Provider Other First Name:
MAGDA ELAINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518008770
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1465
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-1465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-785-6410
Provider Business Mailing Address Fax Number:
787-785-6468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
B1 CALLE SANTA CRUZ
Provider Second Line Business Practice Location Address:
STE 502
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-6946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-785-6410
Provider Business Practice Location Address Fax Number:
787-785-6468
Provider Enumeration Date:
02/09/2007

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: 207W00000X , with the licence number:  13459 , 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)





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