1588099337 NPI number — DRA.CARMENJ.LABOYTORRES PSC

Table of content: STEVEN ALEXANDER BLISS RN (NPI 1104594506)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588099337 NPI number — DRA.CARMENJ.LABOYTORRES PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRA.CARMENJ.LABOYTORRES PSC
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:
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:
1588099337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12107 CALLE TRAPICHE
Provider Second Line Business Mailing Address:
URB.ESTANCIAS DEL MAYORAL
Provider Business Mailing Address City Name:
VILLALBA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-847-6593
Provider Business Mailing Address Fax Number:
787-847-8272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12107 CALLE TRAPICHE
Provider Second Line Business Practice Location Address:
URB.ESTANCIAS DEL MAYORAL
Provider Business Practice Location Address City Name:
VILLALBA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-847-6593
Provider Business Practice Location Address Fax Number:
787-847-8272
Provider Enumeration Date:
09/12/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LABOY
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
JULIA
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
787-847-6593

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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