1134244577 NPI number — RECINTO UNIVERSITARIO DE MAYAGUEZ

Table of content: (NPI 1134244577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134244577 NPI number — RECINTO UNIVERSITARIO DE MAYAGUEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RECINTO UNIVERSITARIO DE MAYAGUEZ
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:
1134244577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-9000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-832-4040
Provider Business Mailing Address Fax Number:
787-834-1538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
259 ALFONSO VALDEZ BLVD.
Provider Second Line Business Practice Location Address:
HEALTH SERVICES DEPARTMENT RUM
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-265-3865
Provider Business Practice Location Address Fax Number:
787-834-1538
Provider Enumeration Date:
03/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RIVERA SANTOS
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
I
Authorized Official Title or Position:
CHANCELLOR
Authorized Official Telephone Number:
787-832-4040

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QD0000X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0100X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1000X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 330 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 37 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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