1750697165 NPI number — VOCATIONAL SCHOOL DR. PEDRO PEREA FAJARDO

Table of content: MRS. MARIETTA ANNETTE COTE RN (NPI 1407009590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750697165 NPI number — VOCATIONAL SCHOOL DR. PEDRO PEREA FAJARDO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VOCATIONAL SCHOOL DR. PEDRO PEREA FAJARDO
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:
1750697165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 4184
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-810-0574
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB. HACIENDAS DEL MIRAMAR 470
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CABO ROJO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-810-0574
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
JIMENEZ
Authorized Official First Name:
PEDRO
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-833-0865

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  2760 , 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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