1396887196 NPI number — CESAR VIANA M.D.

Table of content: CESAR VIANA M.D. (NPI 1396887196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396887196 NPI number — CESAR VIANA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VIANA
Provider First Name:
CESAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1396887196
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
B1 CALLE SAN MATEO
Provider Second Line Business Mailing Address:
URB.SAN PEDRO
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00949-5406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-251-1969
Provider Business Mailing Address Fax Number:
787-798-4118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KM1.5 CALLE 863
Provider Second Line Business Practice Location Address:
PAJAROS
Provider Business Practice Location Address City Name:
TOA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00949-5406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-798-4118
Provider Business Practice Location Address Fax Number:
787-798-4118
Provider Enumeration Date:
02/12/2007

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: 208000000X , with the licence number:  06795 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: 06795 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9-8939 VI . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6795 . This is a "COSVI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6795 . This is a "CIGNA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6795 . This is a "PALIC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6795 . This is a "MAPFRE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 068875 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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