1285718791 NPI number — BERTIS MARIA DELGADO FIGUEROA PH.D.

Table of content: BERTIS MARIA DELGADO FIGUEROA PH.D. (NPI 1285718791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285718791 NPI number — BERTIS MARIA DELGADO FIGUEROA PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELGADO FIGUEROA
Provider First Name:
BERTIS
Provider Middle Name:
MARIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1285718791
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2080 CARR 8177
Provider Second Line Business Mailing Address:
COND. TORRE DE LOS FRAILES APT. 12-K
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00966-3760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-790-0904
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
I107 AVE. ORTEGON
Provider Second Line Business Practice Location Address:
CAPARRA GALLERY SUITE 307
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00966-2520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-378-4868
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006

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: 103TC0700X , with the licence number:  0052 , 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: 66055941824F . This is a "MCS ADVANTAGE CLASSICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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