1043310550 NPI number — DR. SAMUEL PADILLA ROSA

Table of content: DR. SAMUEL PADILLA ROSA (NPI 1043310550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043310550 NPI number — DR. SAMUEL PADILLA ROSA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PADILLA ROSA
Provider First Name:
SAMUEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
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:
1043310550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1096
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANATI
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00674-1096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-854-3851
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
J23 CALLE ELLIOT VELEZ
Provider Second Line Business Practice Location Address:
URB ATENAS
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-4616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-3851
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2006

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: 174400000X , with the licence number:  7930 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 7930 , 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: 10209 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1653 . This is a "PREFERRED MEDICARE CHOISE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 81764 . This is a "TRIPLE SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7530053 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: PE2000 . This is a "PALIC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 825444 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 81764 . This is a "BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 212407 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 437930 . This is a "U.I.A." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660609707 . This is a "MAPFRE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 69646 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1380 . This is a "AMERICAN HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: E27914 . This is a "UPIN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com