1841280534 NPI number — POLICLINICA RIO PIEDRAS

Table of content: (NPI 1841280534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841280534 NPI number — POLICLINICA RIO PIEDRAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POLICLINICA RIO PIEDRAS
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:
1841280534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1056 CALLE FERROCARRIL
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00925-3028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-764-8937
Provider Business Mailing Address Fax Number:
787-763-4278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1056 CALLE FERROCARRIL
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00925-3028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-764-8937
Provider Business Practice Location Address Fax Number:
787-763-4278
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ DAVIS
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-764-8937

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , 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: 500363E . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40073 . This is a "PREFERRED CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 201873 . This is a "PREFERRED" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 84715 . This is a "TRIPLE-S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 061917 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 500360E . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 31626 . This is a "UIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 500409E . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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