1558689752 NPI number — MARIBEL DE JESUS

Table of content: DR. SYLVANUS OLUWATOYOSI TOYOSI MD (NPI 1417213877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558689752 NPI number — MARIBEL DE JESUS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DE JESUS
Provider First Name:
MARIBEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DE JESUS
Provider Other First Name:
MARIBEL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTL
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1558689752
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
JUAN H. CINTRON 317
Provider Second Line Business Mailing Address:
ESTANCIAS DEL GOLF
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00730-0515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-259-3398
Provider Business Mailing Address Fax Number:
787-812-4818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE VOLGA 94
Provider Second Line Business Practice Location Address:
URB. VILLA SERENA
Provider Business Practice Location Address City Name:
SANTA ISABEL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-259-3398
Provider Business Practice Location Address Fax Number:
787-812-4818
Provider Enumeration Date:
05/12/2010

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: 174400000X , with the licence number:  487 , 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)