1376958249 NPI number — ALEXANDRA CAMPIS-VALENTIN M.D.

Table of content: ALEXANDRA CAMPIS-VALENTIN M.D. (NPI 1376958249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376958249 NPI number — ALEXANDRA CAMPIS-VALENTIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPIS-VALENTIN
Provider First Name:
ALEXANDRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAMPIS
Provider Other First Name:
ALEXANDRA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1376958249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 AVE ROOSEVELT OFICINA 408
Provider Second Line Business Mailing Address:
CLINICA LAS AMERICAS HATO REY
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-751-8739
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 AVE ROOSEVELT
Provider Second Line Business Practice Location Address:
CLINICA LAS AMERICAS 408
Provider Business Practice Location Address City Name:
HATO REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
787-751-8739
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2014

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: 207R00000X , with the licence number:  19567 , 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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