1700425899 NPI number — MRS. CYNTHIA VILMARY RIJOS RIJOS MS

Table of content: MRS. CYNTHIA VILMARY RIJOS RIJOS MS (NPI 1700425899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700425899 NPI number — MRS. CYNTHIA VILMARY RIJOS RIJOS MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIJOS RIJOS
Provider First Name:
CYNTHIA
Provider Middle Name:
VILMARY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS
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:
1700425899
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR 6 BOX 7301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00953-9346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-415-7022
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
REPTO MARIELA D12 BO QUEBRADA CRUZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00953-9346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-415-7022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2020

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: 103TS0200X , with the licence number:  6552 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 15132 , 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: 5522 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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