1669562112 NPI number — CENTRO-GINECO OBSTETRICO DR LUIS E. VAZQUEZ ZAYAS C.S.P.

Table of content: (NPI 1669562112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669562112 NPI number — CENTRO-GINECO OBSTETRICO DR LUIS E. VAZQUEZ ZAYAS C.S.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO-GINECO OBSTETRICO DR LUIS E. VAZQUEZ ZAYAS C.S.P.
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:
1669562112
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3177
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-3177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-620-1150
Provider Business Mailing Address Fax Number:
787-620-1152

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
EDIF. LORENZO VIZCARRONDO C-1, CALLE IGNACIO ARZUAGA
Provider Second Line Business Practice Location Address:
ESQ. MUNOZ RIVERA
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-752-1490
Provider Business Practice Location Address Fax Number:
787-620-1152
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VAZQUEZ ZAYAS
Authorized Official First Name:
DR. LUIS E.
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-752-1490

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X , with the licence number:  5859 , 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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