1609115203 NPI number — MRS. ELIZABETH ARLEEN CABAN LCDA

Table of content: MRS. ELIZABETH ARLEEN CABAN LCDA (NPI 1609115203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609115203 NPI number — MRS. ELIZABETH ARLEEN CABAN LCDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CABAN
Provider First Name:
ELIZABETH
Provider Middle Name:
ARLEEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCDA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CABAN
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
ARLEEN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609115203
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
552 AVE JOSE A CEDENO
Provider Second Line Business Mailing Address:
ARECIBO MINI PLAZA SUITE 4
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00612-3963
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-479-2229
Provider Business Mailing Address Fax Number:
787-915-5590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
552 AVE JOSE A CEDENO
Provider Second Line Business Practice Location Address:
ARECIBO MINI PLAZA SUITE 4
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-3963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-479-2229
Provider Business Practice Location Address Fax Number:
787-915-5590
Provider Enumeration Date:
02/04/2013

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: 103T00000X , with the licence number:  3193 , 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)





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