1386390649 NPI number — MARIA ALEJANDRA PORTELA VAZQUEZ

Table of content: MARIA ALEJANDRA PORTELA VAZQUEZ (NPI 1386390649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386390649 NPI number — MARIA ALEJANDRA PORTELA VAZQUEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PORTELA VAZQUEZ
Provider First Name:
MARIA
Provider Middle Name:
ALEJANDRA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1386390649
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 AVE ARTERIAL HOSTOS
Provider Second Line Business Mailing Address:
COND. JARDINES DE CUENCA, APT. 8016
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:
787-201-4435
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
195 AVE ARTERIAL HOSTOS
Provider Second Line Business Practice Location Address:
COND. JARDINES DE CUENCA, APT. 8016
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-201-4435
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/25/2022

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com