1952447542 NPI number — MRS. MICHELLE MERCEDES MIELES SOTO MSW

Table of content: MRS. MICHELLE MERCEDES MIELES SOTO MSW (NPI 1952447542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952447542 NPI number — MRS. MICHELLE MERCEDES MIELES SOTO MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIELES SOTO
Provider First Name:
MICHELLE
Provider Middle Name:
MERCEDES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
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:
1952447542
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:
PO BOX 9550
Provider Second Line Business Mailing Address:
COTTO STATION
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-878-3552
Provider Business Mailing Address Fax Number:
787-879-8633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ANTIGUO HOSPITAL DE DISTRITO 2DO PISO CARR 129
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-3552
Provider Business Practice Location Address Fax Number:
787-879-8633
Provider Enumeration Date:
01/30/2007

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: 1041C0700X , with the licence number:  8890 , 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)





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