1376759779 NPI number — TRATAMIENTO NEUROLOGICO Y NEUMOLOGICO DEL SUENO

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 1376759779 NPI number — TRATAMIENTO NEUROLOGICO Y NEUMOLOGICO DEL SUENO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRATAMIENTO NEUROLOGICO Y NEUMOLOGICO DEL SUENO
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:
1376759779
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 846
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:
00613-0846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-816-0315
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 CALLE GAUTIER BENITEZ
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:
00612-4418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-816-0315
Provider Business Practice Location Address Fax Number:
787-880-1011
Provider Enumeration Date:
05/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
MARGARITA
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
787-816-0315

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  6372 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 9371 , 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: 81388 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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