1588486369 NPI number — MAELIS DELA CARIDAD FEE ESTEVEZ

Table of content: MRS. ERIN D PORTER BHRS (NPI 1821200791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588486369 NPI number — MAELIS DELA CARIDAD FEE ESTEVEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEE ESTEVEZ
Provider First Name:
MAELIS
Provider Middle Name:
DELA CARIDAD
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:
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:
1588486369
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6220 NW 173RD ST APT 710
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33015-4528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-563-6939
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10300 SW 72ND ST STE 114
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33173-3038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-981-3789
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2024

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: 103K00000X , with the licence number:  RBT-24-374611 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com