1215255039 NPI number — MRS. ILEANA MARGARITA ACOSTA-SALCEDO RN

Table of content: MRS. ILEANA MARGARITA ACOSTA-SALCEDO RN (NPI 1215255039)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215255039 NPI number — MRS. ILEANA MARGARITA ACOSTA-SALCEDO RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACOSTA-SALCEDO
Provider First Name:
ILEANA
Provider Middle Name:
MARGARITA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ACOSTA
Provider Other First Name:
ILEANA
Provider Other Middle Name:
MARGARITA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215255039
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CMR 464 BOX 2014
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
4997214759889
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USA MEDDAC BAVARIA
Provider Second Line Business Practice Location Address:
CMR 411, BLDG 700, ROSE BARRACKS
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
499662834719
Provider Business Practice Location Address Fax Number:
499662834721
Provider Enumeration Date:
05/05/2010

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: 163W00000X , with the licence number:  00669 , 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: VAD000 . This is a "UPIN" identifier . This identifiers is of the category "OTHER".