1134921901 NPI number — MISS AIDA ESTHER FELICIANO ATO

Table of content: MISS AIDA ESTHER FELICIANO ATO (NPI 1134921901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134921901 NPI number — MISS AIDA ESTHER FELICIANO ATO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELICIANO
Provider First Name:
AIDA
Provider Middle Name:
ESTHER
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
ATO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FELICIANO
Provider Other First Name:
AIDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1134921901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. VILLA LINDA
Provider Second Line Business Mailing Address:
CALLE TORTOLA 435
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-633-0141
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA NO.2 INTERIOR, SECTOR LOLO FORTE
Provider Second Line Business Practice Location Address:
BARRIO PUENTE PENA
Provider Business Practice Location Address City Name:
CAMUY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-956-0297
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2025

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: 224ZR0403X , with the licence number:  1318 , 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)





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