1821253873 NPI number — INTERNAL MEDICINE PERIOPERATIVE CONSULTANTS, PSC

Table of content: (NPI 1821253873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821253873 NPI number — INTERNAL MEDICINE PERIOPERATIVE CONSULTANTS, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERNAL MEDICINE PERIOPERATIVE CONSULTANTS, PSC
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:
1821253873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PMB 157 PO BOX 2000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERCEDITA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-841-5549
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE TITO CASTRO SUITE 717
Provider Second Line Business Practice Location Address:
TORRE MEDICA SAN LUCAS 909
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-841-5549
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANTIAGO
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-841-5549

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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