1336767771 NPI number — CONSULTORIO MEDICO DR VICTOR A ZAPATA LLC

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 1336767771 NPI number — CONSULTORIO MEDICO DR VICTOR A ZAPATA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONSULTORIO MEDICO DR VICTOR A ZAPATA LLC
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:
1336767771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 752
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-0752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-740-7945
Provider Business Mailing Address Fax Number:
787-780-7430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE TNTE NELSON MARTINEZ EDIF 500
Provider Second Line Business Practice Location Address:
PLAZA CHEVERE LOCAL 5 ALTURAS DE FLAMBOYAN
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-740-7945
Provider Business Practice Location Address Fax Number:
787-780-7430
Provider Enumeration Date:
07/13/2020

Additional Information

Authorized Official

Authorized Official Last Name:
VICTOR
Authorized Official First Name:
ZAPATA GUZMAN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-740-7945

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1699782235 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com