1659870640 NPI number — CARIBBEAN STEWARDSHIP & INFUSION SERVICES

Table of content: JERI ANN AZURE PHD (NPI 1427377712)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659870640 NPI number — CARIBBEAN STEWARDSHIP & INFUSION SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN STEWARDSHIP & INFUSION SERVICES
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:
1659870640
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 712
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERCEDITA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00715-0712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2053 PONCE BY PASS CENTRO CARIBE BLDG. SUITE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-987-8050
Provider Business Practice Location Address Fax Number:
787-987-8050
Provider Enumeration Date:
02/06/2018

Additional Information

Authorized Official

Authorized Official Last Name:
LUGO VELEZ
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
JORGE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-688-7327

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , with the licence number:  167798 , 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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