1295144244 NPI number — MRS. MARIA DEL CARMEN MONTANEZ MS

Table of content: MRS. MARIA DEL CARMEN MONTANEZ MS (NPI 1295144244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295144244 NPI number — MRS. MARIA DEL CARMEN MONTANEZ MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTANEZ
Provider First Name:
MARIA
Provider Middle Name:
DEL CARMEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS
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:
1295144244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 AVE R CORDERO STE 140
Provider Second Line Business Mailing Address:
PMB 393
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725-4303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-220-3227
Provider Business Mailing Address Fax Number:
787-745-3660

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 CALLE GAUTIER BENITEZ
Provider Second Line Business Practice Location Address:
PD PLAZA LOCAL 6
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-5553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-220-3227
Provider Business Practice Location Address Fax Number:
787-745-3660
Provider Enumeration Date:
08/04/2014

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: 235Z00000X , with the licence number:  239 , 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)





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