1013914258 NPI number — DR. PEDRO SANABRIA MD

Table of content: DR. PEDRO SANABRIA MD (NPI 1013914258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013914258 NPI number — DR. PEDRO SANABRIA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANABRIA
Provider First Name:
PEDRO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1013914258
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1323
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GURABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00778-1323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-737-6082
Provider Business Mailing Address Fax Number:
787-737-6798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 D12 EL VIVERO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GURABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-737-6082
Provider Business Practice Location Address Fax Number:
787-737-6082
Provider Enumeration Date:
07/01/2005

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: 208D00000X , with the licence number:  5534 , 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: 6580008 . This is a "HUMANA - PROVIDER NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 065428 . This is a "LA CRUZ AZUL - PROVIDER #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1304 . This is a "FIRST PLUS - PROVIDER #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 04351 . This is a "AMERICAN HEALTH - PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 31-60543 . This is a "UNION INDEP AUTE - PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: PR0444 . This is a "PALIC - PROVIDER #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 15534 . This is a "CIGNA - PROVIDER #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1304 . This is a "INTER MED CARD - PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25835 . This is a "TRIPLE S - PROVIDER NUM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 775171 . This is a "HUMANA GOLD PLUS - PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3511A . This is a "PREFER MED CHOI- PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 500117SE . This is a "MEDICARE MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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