1215439765 NPI number — CARIBBEAN ENDOCRINOLOGY CARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215439765 NPI number — CARIBBEAN ENDOCRINOLOGY CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN ENDOCRINOLOGY CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1215439765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 32126
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00732-2126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-432-1297
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB UNIVERSITY GARDENS CALLE YALE 196, APT 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-432-1297
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ORTIZ-NIEVES
Authorized Official First Name:
ANDRES
Authorized Official Middle Name:
JOSE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-432-1297

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  19096 , 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: 1831449560 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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