1184667792 NPI number — DR. LUMA AL-ATTAR MD

Table of content: DR. LUMA AL-ATTAR MD (NPI 1184667792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184667792 NPI number — DR. LUMA AL-ATTAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL-ATTAR
Provider First Name:
LUMA
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:
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:
1184667792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 CARR 693
Provider Second Line Business Mailing Address:
PMB 152
Provider Business Mailing Address City Name:
DORADO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00646-4816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-854-1900
Provider Business Mailing Address Fax Number:
787-854-1918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA NUMBER 2
Provider Second Line Business Practice Location Address:
TORRE MEDICA II, SUITE 260 DOCTORS' CENTER HOSPITAL
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-1900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2006

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: 207W00000X , with the licence number:  ME87876 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 16858 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: D0071450 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207W00000X , with the licence number: 0101243120 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2679639-00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0027791 . This is a "MEDICARE ID" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".