1326161563 NPI number — INSTITUTO DE ENDOUROLOGIA Y UROLOGIA DEL NORTE, PSC

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 1326161563 NPI number — INSTITUTO DE ENDOUROLOGIA Y UROLOGIA DEL NORTE, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTO DE ENDOUROLOGIA Y UROLOGIA DEL NORTE, PSC
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:
1326161563
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1845
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00613-1845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-880-2818
Provider Business Mailing Address Fax Number:
787-880-2969

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE DR. ROSES ARTAU #156
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-880-2818
Provider Business Practice Location Address Fax Number:
787-880-2969
Provider Enumeration Date:
04/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALLENDE
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-880-2818

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  9019 , 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: 9613 . This is a "FIRST PLUS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1120A . This is a "PMC MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 601367 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 06769 . This is a "CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9613 . This is a "FIRST MEDICAL INTERNATONA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6130076 . This is a "HUMANA HEALT PLAN OF PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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