1932328812 NPI number — QUIMIO AMB DR RAUL MORALES BORGES

Table of content: (NPI 1932328812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932328812 NPI number — QUIMIO AMB DR RAUL MORALES BORGES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUIMIO AMB DR RAUL MORALES BORGES
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:
1932328812
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:
29 CALLE WASHINGTON
Provider Second Line Business Mailing Address:
SUITE # 104
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00907-1510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-722-0412
Provider Business Mailing Address Fax Number:
787-723-0554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 CALLE WASHINGTON
Provider Second Line Business Practice Location Address:
SUITE # 104
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-722-0412
Provider Business Practice Location Address Fax Number:
787-723-0554
Provider Enumeration Date:
04/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
RAUL
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-722-0412

Provider Taxonomy Codes

  • Taxonomy code: 261QX0200X , with the licence number:  10718 , 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: 12940 . This is a "TRIPLE S PROVIDER NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com