1699944090 NPI number — MS. MARIA LOUISA CRESPO MT(ASCP)

Table of content: (NPI 1093326308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699944090 NPI number — MS. MARIA LOUISA CRESPO MT(ASCP)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRESPO
Provider First Name:
MARIA
Provider Middle Name:
LOUISA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MT(ASCP)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BACTERIOLOGICO SAN ANTONIO
Provider Other First Name:
LABORATORIO
Provider Other Middle Name:
CLINICO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1699944090
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 791
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00690-0791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-890-6161
Provider Business Mailing Address Fax Number:
787-890-6161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1065 AVE GENERAL RAMEY
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00690-1117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-890-6161
Provider Business Practice Location Address Fax Number:
787-890-6161
Provider Enumeration Date:
02/29/2008

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: 291U00000X , with the licence number:  761 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 246QM0706X , with the licence number: 2870 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 051502 . This is a "BLUE CROSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 800386 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: LA 0179 . This is a "PAN AMERICAN LIFE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 5599 . This is a "AMERICAN HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6030045 . This is a "HUMANA HEALTH INS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 0152 . This is a "INTERNATIONAL MEDICAL CARD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30731 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: A0170 . This is a "FIRST PLUS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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