1770849457 NPI number — MS. LOURDES DE LOS ANGELES SOLER M.A.

Table of content: MS. LOURDES DE LOS ANGELES SOLER M.A. (NPI 1770849457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770849457 NPI number — MS. LOURDES DE LOS ANGELES SOLER M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLER
Provider First Name:
LOURDES
Provider Middle Name:
DE LOS ANGELES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SOLER
Provider Other First Name:
LOURDES
Provider Other Middle Name:
DE LOS ANGELES
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1770849457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9787
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00908-0787
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HA6 CALLE PALMA SOLA
Provider Second Line Business Practice Location Address:
GARDEN HILLS
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00966-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-923-5996
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2012

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: 103TC1900X , with the licence number:  1499 , 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)





Copyright © 2007-2024 www.npivalidator.com