1538106893 NPI number — GILBERTO VAZQUEZ PEREZ

Table of content: (NPI 1538106893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538106893 NPI number — GILBERTO VAZQUEZ PEREZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GILBERTO VAZQUEZ PEREZ
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:
CENTRO RADIOLOGICO DE LA MONTANA
Provider Other Organization Name Type Code:
4
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:
1538106893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 72 BOX 3951
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NARANJITO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00719-9720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-869-2687
Provider Business Mailing Address Fax Number:
787-869-0536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 152 INTERSECCION 803
Provider Second Line Business Practice Location Address:
BO CEDRO ARRIBA
Provider Business Practice Location Address City Name:
NARANJITO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00719-9720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-869-2687
Provider Business Practice Location Address Fax Number:
787-869-0536
Provider Enumeration Date:
06/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VAZQUEZ PEREZ
Authorized Official First Name:
GILBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-869-2687

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: X000230 . This is a "MENONITA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 511199 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660506074 . This is a "MAPFRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 810039 . This is a "MEDICARE Y MUCHO MAS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 85042 . This is a "TRIPLE S" identifier . This identifiers is of the category "OTHER".
  • Identifier: 85042 . This is a "TRIPLE C" identifier . This identifiers is of the category "OTHER".
  • Identifier: 051722 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7190123 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1143 . This is a "INTERNATIONAL MEDICAL CAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660506074 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7190123 . This is a "HUMANA REFORMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7190123 . This is a "HUMANA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: RX0125 . This is a "PALIC" identifier . This identifiers is of the category "OTHER".




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