1518943109 NPI number — DR. JENARO RAMON BOU-UMPIERRE MD

Table of content: DR. JENARO RAMON BOU-UMPIERRE MD (NPI 1518943109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518943109 NPI number — DR. JENARO RAMON BOU-UMPIERRE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOU-UMPIERRE
Provider First Name:
JENARO
Provider Middle Name:
RAMON
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:
1518943109
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE BOU 57 INT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COROZOL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00783
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-859-1545
Provider Business Mailing Address Fax Number:
787-859-1545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE BOU 57 INT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COROZOL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-859-1545
Provider Business Practice Location Address Fax Number:
787-859-1545
Provider Enumeration Date:
12/16/2005

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: 208000000X , with the licence number:  6835 , 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)

  • Identifier: 98423 . This is a "SEGURO DE SERVICIAS DE SA" identifier . This identifiers is of the category "OTHER".
  • Identifier: PE0321 . This is a "PAN AMERICAN LIFE INS CO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 208259 . This is a "PREFERRED HEALTH PLAN INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 416835 . This is a "PLAN DE SALUD UIA INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1296835PE . This is a "GLOBAL HEALTH PLAN INC CO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1296835PE . This is a "AMERICAN HEALTH INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 26835 . This is a "LIFE INSURANCE CO" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 068391 . This is a "LA CRUZ AZUL DE PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6460017 . This is a "HUMANA HEALTH INSURANCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 41745 . This is a "PROSSAM" identifier . This identifiers is of the category "OTHER".




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