1831166594 NPI number — DR. GLADYS PEREZ-KRAFT M.D.

Table of content: DR. GLADYS PEREZ-KRAFT M.D. (NPI 1831166594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831166594 NPI number — DR. GLADYS PEREZ-KRAFT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ-KRAFT
Provider First Name:
GLADYS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1831166594
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29134
Provider Second Line Business Mailing Address:
RADIOLOGIA RCM
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00929-0134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-777-3535
Provider Business Mailing Address Fax Number:
787-777-3855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ASEM RADIOLOGIA 2DO PISO
Provider Second Line Business Practice Location Address:
CENTRO MEDICO DE PR, BO. MONACILLOS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-777-3535
Provider Business Practice Location Address Fax Number:
787-777-3855
Provider Enumeration Date:
03/02/2006

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: 2085R0202X , with the licence number:  5807 , 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)