1255997979 NPI number — FACILIDADES MEDICAS ASOCIADAS CORP.

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 1255997979 NPI number — FACILIDADES MEDICAS ASOCIADAS CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FACILIDADES MEDICAS ASOCIADAS CORP.
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:
1255997979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9185
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUMACAO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00792-9185
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-285-0655
Provider Business Mailing Address Fax Number:
787-285-4060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 AVE FONT MARTELO STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791-3346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-285-0655
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ORTIZ
Authorized Official First Name:
ITZIANETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER EXECUTIVE
Authorized Official Telephone Number:
787-619-7380

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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