1205414703 NPI number — DILLIAN MARIE CURBELO

Table of content: DILLIAN MARIE CURBELO (NPI 1205414703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205414703 NPI number — DILLIAN MARIE CURBELO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CURBELO
Provider First Name:
DILLIAN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1205414703
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 3 BOX 11752
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMUY
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00627-9671
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-356-3604
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. #2 KM 77.6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-0061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-880-4240
Provider Business Practice Location Address Fax Number:
787-880-2872
Provider Enumeration Date:
03/29/2021

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: 183700000X , with the licence number:  006374 , 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: 006374 . This is a "HEALTH PROFESSIONAL REGISTRY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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