1447055660 NPI number — NICOLE SHAIRY DIAZ ALICEA RN

Table of content: NICOLE SHAIRY DIAZ ALICEA RN (NPI 1447055660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447055660 NPI number — NICOLE SHAIRY DIAZ ALICEA RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIAZ ALICEA
Provider First Name:
NICOLE
Provider Middle Name:
SHAIRY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DIAZ ALICEA
Provider Other First Name:
NICOLE
Provider Other Middle Name:
SHAIRY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447055660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB TURABO GARDENS CALLE 18 Z-11
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-246-6498
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL AUXILIO MUTUO, AVE PONCE DE LEON STOP 37 1/2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2025

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: 163WE0003X , with the licence number:  85973 , 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)