1306801550 NPI number — DR. ANOUK UNDERWOOD O.D.

Table of content: DR. ANOUK UNDERWOOD O.D. (NPI 1306801550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306801550 NPI number — DR. ANOUK UNDERWOOD O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UNDERWOOD
Provider First Name:
ANOUK
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
UNDERWOOD
Provider Other First Name:
ANOUK
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306801550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EDIFICIO FAMMA
Provider Second Line Business Mailing Address:
PMB 345 AVE ASHFOR 1357
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00907-1111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-513-4187
Provider Business Mailing Address Fax Number:
787-258-8225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PROFESIONAL HOSPITAL NUM 10
Provider Second Line Business Practice Location Address:
AVE LAS CUMBRES SUITE 104
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969-1111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-513-4187
Provider Business Practice Location Address Fax Number:
787-258-8225
Provider Enumeration Date:
04/19/2006

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: 152W00000X , with the licence number:  600 , 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)