1659902187 NPI number — NATIVIDAD DUMONT II TECNICO FARMACIA

Table of content: NATIVIDAD DUMONT II TECNICO FARMACIA (NPI 1659902187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659902187 NPI number — NATIVIDAD DUMONT II TECNICO FARMACIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUMONT
Provider First Name:
NATIVIDAD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
II
Provider Credential Text:
TECNICO FARMACIA
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:
1659902187
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BO. MARAVILLA ESTES CARR.124 K.M 0.4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS MARIAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00670
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-246-3144
Provider Business Mailing Address Fax Number:
787-280-4188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO. MARAVILLA ESTE, CARR. 124 K.M.0.4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS MARIAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-896-1111
Provider Business Practice Location Address Fax Number:
787-280-4188
Provider Enumeration Date:
02/03/2020

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: 183700000X , with the licence number:  005388 , 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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