1972734747 NPI number — LABORATORIO DE SUENO Y NEUROLOGIA DE PR

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972734747 NPI number — LABORATORIO DE SUENO Y NEUROLOGIA DE PR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO DE SUENO Y NEUROLOGIA DE PR
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:
6
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:
1972734747
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 GRAN BULEVAR PASEOS
Provider Second Line Business Mailing Address:
SUITE 112 PMB 182
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-5955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-473-8900
Provider Business Mailing Address Fax Number:
787-251-8484

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
B1 CALLE SANTA CRUZ STE 201
Provider Second Line Business Practice Location Address:
CARIMED PLAZA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-6943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-473-8900
Provider Business Practice Location Address Fax Number:
787-946-1634
Provider Enumeration Date:
07/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BRUNO
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-692-8259

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com