1841632916 NPI number — IDALIA REYES VALENCIA PT

Table of content: IDALIA REYES VALENCIA PT (NPI 1841632916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841632916 NPI number — IDALIA REYES VALENCIA PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REYES VALENCIA
Provider First Name:
IDALIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
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:
1841632916
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE 44 NUM 702
Provider Second Line Business Mailing Address:
URB FAIR VIEW
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-761-3938
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ROBERTO CLEMENTE HSING
Provider Second Line Business Practice Location Address:
NUM 51 VILLA CAROLINA
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00987-7329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-768-9400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2013

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: 225100000X , with the licence number:  000204 , 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: 000204 . This is a "NUM LICENCIA TERAPISTA FISICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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