1013014422 NPI number — CARIBBEAN RADIATION ONCOLOGY CENTER PSC

Table of content: (NPI 1013014422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013014422 NPI number — CARIBBEAN RADIATION ONCOLOGY CENTER PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN RADIATION ONCOLOGY CENTER PSC
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:
1013014422
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 958
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-0958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-993-2800
Provider Business Mailing Address Fax Number:
787-778-5472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11-25 CARR. 174
Provider Second Line Business Practice Location Address:
URB. SANTA ROSA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-6609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-993-2800
Provider Business Practice Location Address Fax Number:
787-778-5472
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SERRANO-OJEDA
Authorized Official First Name:
PEDRO
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-993-2800

Provider Taxonomy Codes

  • Taxonomy code: 261QX0203X ; 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