1902883242 NPI number — KYRIOS INTERNAL MEDICINE SERVICES

Table of content: (NPI 1902883242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902883242 NPI number — KYRIOS INTERNAL MEDICINE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KYRIOS INTERNAL MEDICINE SERVICES
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:
1902883242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1492
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HATILLO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00659-1492
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-872-7095
Provider Business Mailing Address Fax Number:
787-872-7095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7342 AVE AGUSTIN RAMOS CALERO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISABELA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00662-3466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-872-7095
Provider Business Practice Location Address Fax Number:
787-872-7095
Provider Enumeration Date:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SANANTONIO
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
787-872-7095

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 212571 . This is a "UTI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89563R10 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: PE3701 . This is a "CANADA LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89563 . This is a "MEDICARE OPTIMOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6620043 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9864 . This is a "INTCARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1849 . This is a "PMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30255 . This is a "AMPR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100193 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100097W . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: PE307 . This is a "PARLIC" identifier . This identifiers is of the category "OTHER".




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