1437134327 NPI number — MRS. YARIMAR MARIA SANDOVAL JIMENEZ AUD

Table of content: MRS. YARIMAR MARIA SANDOVAL JIMENEZ AUD (NPI 1437134327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437134327 NPI number — MRS. YARIMAR MARIA SANDOVAL JIMENEZ AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANDOVAL JIMENEZ
Provider First Name:
YARIMAR
Provider Middle Name:
MARIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AUD
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:
1437134327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9741
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CIDRA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00739-8741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-714-1315
Provider Business Mailing Address Fax Number:
787-714-1315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 CALLE BARCELO
Provider Second Line Business Practice Location Address:
ESQUINO CARR 173
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739-3446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-714-1315
Provider Business Practice Location Address Fax Number:
787-714-1315
Provider Enumeration Date:
12/13/2005

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: 231H00000X , with the licence number:  460 , 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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