1821071556 NPI number — CESAR A DEL VALLE & MAITE L ROLON

Table of content: KRISTY MARIE DEHNE ACNP (NPI 1558912824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821071556 NPI number — CESAR A DEL VALLE & MAITE L ROLON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CESAR A DEL VALLE & MAITE L ROLON
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:
6
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:
1821071556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 142292
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00614-2292
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-879-0749
Provider Business Mailing Address Fax Number:
787-816-4307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 490 KM 0 2
Provider Second Line Business Practice Location Address:
BO HATO ARRIBA
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-879-0749
Provider Business Practice Location Address Fax Number:
787-816-4307
Provider Enumeration Date:
11/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ROLON
Authorized Official First Name:
MAITE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-879-0749

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  886 , 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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