1871717389 NPI number — DR. YADITZA COLON SANTINI MD PEDIATRIC SPECIAL

Table of content: DR. YADITZA COLON SANTINI MD PEDIATRIC SPECIAL (NPI 1871717389)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871717389 NPI number — DR. YADITZA COLON SANTINI MD PEDIATRIC SPECIAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLON SANTINI
Provider First Name:
YADITZA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD PEDIATRIC SPECIAL
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:
1871717389
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:
ADELFA B 23 LOMAS VERDES
Provider Second Line Business Mailing Address:
B23 ADELFA STREET LOMAS VERDES
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00956-3130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-785-3605
Provider Business Mailing Address Fax Number:
787-880-6263

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE SAN LUIS STREET #129 KM NO 0.1
Provider Second Line Business Practice Location Address:
DR CAYETANO COIL Y TOSTE HOSPITAL
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-7272
Provider Business Practice Location Address Fax Number:
787-650-7300
Provider Enumeration Date:
04/13/2007

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: 208000000X , with the licence number:  9381 , 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: 008226 . This is a "TEM MEDICAL EXAMINER TRIB" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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