1437425030 NPI number — LAS AMERICAS PAIN INTERVENTIONAL CENTER PSC

Table of content: (NPI 1437425030)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437425030 NPI number — LAS AMERICAS PAIN INTERVENTIONAL CENTER PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAS AMERICAS PAIN INTERVENTIONAL CENTER PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1437425030
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CROSANDRA A 27
Provider Second Line Business Mailing Address:
PARQUE DE BUCARE
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-200-7550
Provider Business Mailing Address Fax Number:
787-200-7553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LA TORRE DE PLAZA LAS AMERICAS
Provider Second Line Business Practice Location Address:
SUITE 617 525 AVE ROOSEVELT
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:
US
Provider Business Practice Location Address Telephone Number:
787-200-7550
Provider Business Practice Location Address Fax Number:
787-200-7553
Provider Enumeration Date:
03/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
NEGRON
Authorized Official First Name:
AUREA
Authorized Official Middle Name:
TERESA
Authorized Official Title or Position:
PRESIDENT AND OWNER
Authorized Official Telephone Number:
787-200-7550

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X , with the licence number:  14071 , 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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