1073777678 NPI number — DR. REBECCA ALMEYDA MD

Table of content: DR. REBECCA ALMEYDA MD (NPI 1073777678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073777678 NPI number — DR. REBECCA ALMEYDA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALMEYDA
Provider First Name:
REBECCA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALMEYDA RUIZ
Provider Other First Name:
REBECCA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1073777678
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5910 S JELLISON ST APT D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80123-3446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-486-8409
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1020 JOHNSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GOLDEN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80401-6002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-723-5172
Provider Business Practice Location Address Fax Number:
303-914-2682
Provider Enumeration Date:
07/12/2008

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: 207Q00000X , with the licence number:  2012-00576 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: ME 119852 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2012-00576 . This is a "NORTH CAROLINA MEDICAL BOARD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: ME 119852 . This is a "FLORIDA MEDICAL BOARD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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