1750629812 NPI number — MISS MARIA CECILIA MIRANDA ADRIANO RPT

Table of content: MISS MARIA CECILIA MIRANDA ADRIANO RPT (NPI 1750629812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750629812 NPI number — MISS MARIA CECILIA MIRANDA ADRIANO RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADRIANO
Provider First Name:
MARIA CECILIA
Provider Middle Name:
MIRANDA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
RPT
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:
1750629812
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 500409
Provider Second Line Business Mailing Address:
1 LOWER NAVY HILL
Provider Business Mailing Address City Name:
SAIPAN
Provider Business Mailing Address State Name:
MP
Provider Business Mailing Address Postal Code:
96950-0409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
670-234-8950
Provider Business Mailing Address Fax Number:
670-236-8756

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LOWER NAVY HILL
Provider Second Line Business Practice Location Address:
500409 CHALAN KANOA
Provider Business Practice Location Address City Name:
SAIPAN
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
96950-0409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
670-234-8950
Provider Business Practice Location Address Fax Number:
670-236-8756
Provider Enumeration Date:
01/24/2013

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: 225100000X , with the licence number:  0030 , registered in the state of MP ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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