1760887285 NPI number — OPR MD MEDICAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760887285 NPI number — OPR MD MEDICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPR MD MEDICAL SERVICES
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:
1760887285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 CALLE CIELO RUBI
Provider Second Line Business Mailing Address:
URB CIELO DORADO
Provider Business Mailing Address City Name:
VEGA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00692-8814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-404-3267
Provider Business Mailing Address Fax Number:
787-679-5226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 CALLE EDUARTO GEORGETTI
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-679-5226
Provider Business Practice Location Address Fax Number:
787-679-5226
Provider Enumeration Date:
10/27/2014

Additional Information

Authorized Official

Authorized Official Last Name:
PARRILLA PABLOS
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
P
Authorized Official Title or Position:
DIRECTOR MEDICO
Authorized Official Telephone Number:
787-404-3267

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X , 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: 343135 . This is a "CERTIFICACION DE ESTADO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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