1841210218 NPI number — MRS. MAGDA PEREZ ROLON MD

Table of content: MRS. MAGDA PEREZ ROLON MD (NPI 1841210218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841210218 NPI number — MRS. MAGDA PEREZ ROLON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ ROLON
Provider First Name:
MAGDA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1841210218
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE 6
Provider Second Line Business Mailing Address:
ESTANCIAS DE SAN FERNANDO D1
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00985-5216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-869-4721
Provider Business Mailing Address Fax Number:
787-869-0536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 152 INTERSECCION 803
Provider Second Line Business Practice Location Address:
BARRIO CEDRO ARRUBA
Provider Business Practice Location Address City Name:
NARANJITO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-869-4721
Provider Business Practice Location Address Fax Number:
787-869-0536
Provider Enumeration Date:
07/20/2006

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: 208D00000X , with the licence number:  11068 , 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: 2011399 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400287 . This is a "MEDICARE Y MUCHO MAS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04002 . This is a "AMERICAN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 83314 . This is a "TRIPLE S" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7190114 . This is a "HUMANA INSURANCE OF PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1056 . This is a "INTL MEDICAL CARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 83314 . This is a "MEDICARE OPTIMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: M00366 . This is a "PLAN DE SALUD HOSPITAL" identifier . This identifiers is of the category "OTHER".




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