1689065708 NPI number — OFICINA MEDICA DR PINTADO P S C

Table of content: (NPI 1689065708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689065708 NPI number — OFICINA MEDICA DR PINTADO P S C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OFICINA MEDICA DR PINTADO P S C
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:
1689065708
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 CAMINO LOS AQUINOS
Provider Second Line Business Mailing Address:
BOX 129
Provider Business Mailing Address City Name:
TRUJILLO ALTO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00976-7901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-922-6730
Provider Business Mailing Address Fax Number:
787-922-6730

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 AVE PONCE DE LEON
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-922-6730
Provider Business Practice Location Address Fax Number:
787-922-6730
Provider Enumeration Date:
02/11/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PINTADO-GARCIA
Authorized Official First Name:
ISIDORO
Authorized Official Middle Name:
Authorized Official Title or Position:
INCORPORATOR
Authorized Official Telephone Number:
787-922-6730

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  009763 , 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)

  • Identifier: 800041 . This is a "RECIBO INCORPORACION" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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