1437143245 NPI number — DR. CARLOS A CALIMANO GUARDIOLA MD

Table of content: DR. CARLOS A CALIMANO GUARDIOLA MD (NPI 1437143245)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437143245 NPI number — DR. CARLOS A CALIMANO GUARDIOLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALIMANO GUARDIOLA
Provider First Name:
CARLOS
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CALIMANO
Provider Other First Name:
CARLOS
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1437143245
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
W5-5 CALLE PIO BAROJA
Provider Second Line Business Mailing Address:
HUCARES
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-6802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-761-9583
Provider Business Mailing Address Fax Number:
787-283-7401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
W5-5 CALLE PIO BAROJA
Provider Second Line Business Practice Location Address:
HUCARES
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926-6802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-761-9583
Provider Business Practice Location Address Fax Number:
787-283-7401
Provider Enumeration Date:
09/07/2005

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: 208600000X , with the licence number:  5918 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X , with the licence number: 5918 , 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: 067006 . This is a "CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9220021 . This is a "HUMANA INSURANCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2-7425 . This is a "SSS INSURANCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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