1205978962 NPI number — MRS. ZULMA Y RIVERA SORRENTINI LCDA

Table of content: MRS. ZULMA Y RIVERA SORRENTINI LCDA (NPI 1205978962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205978962 NPI number — MRS. ZULMA Y RIVERA SORRENTINI LCDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SORRENTINI
Provider First Name:
ZULMA Y
Provider Middle Name:
RIVERA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCDA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SORRENTINI
Provider Other First Name:
ZULMA Y
Provider Other Middle Name:
RIVERA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCDA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1205978962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MIGRANT HEALTH CENTER, INC
Provider Second Line Business Mailing Address:
P O BOX 7128
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-7128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-805-2900
Provider Business Mailing Address Fax Number:
787-834-1924

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MIGRANT HEALTH CENTER, INC.
Provider Second Line Business Practice Location Address:
BO MONTALVA NUM 23
Provider Business Practice Location Address City Name:
ENSENADA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-821-3377
Provider Business Practice Location Address Fax Number:
787-821-5328
Provider Enumeration Date:
02/12/2007

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: 183500000X , with the licence number:  001790 , 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: 049784 . This is a "REGISTRO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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