1063632065 NPI number — MRS. KARLA E PIZARRO OTL

Table of content: MRS. KARLA E PIZARRO OTL (NPI 1063632065)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063632065 NPI number — MRS. KARLA E PIZARRO OTL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIZARRO
Provider First Name:
KARLA
Provider Middle Name:
E
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTL
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:
1063632065
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB VILLA SERENA ST VOLGA #94
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ISABEL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-845-0599
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB. LAS AGUILAS
Provider Second Line Business Practice Location Address:
ST. 7 I 28
Provider Business Practice Location Address City Name:
COAMO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-813-6838
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2007

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: 225X00000X , with the licence number:  846 , 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: 7510058 . This is a "HUMANA HEALTH PLAN OF PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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