1447576590 NPI number — URO CLINIC CSP

Table of content: (NPI 1447576590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447576590 NPI number — URO CLINIC CSP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URO CLINIC CSP
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:
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:
1447576590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2908
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUAYAMA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00785-2908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-918-1744
Provider Business Mailing Address Fax Number:
787-864-6488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HWY 3
Provider Second Line Business Practice Location Address:
HOSPITAL LAFAYETTE 1ST FLOOR
Provider Business Practice Location Address City Name:
ARROYO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-918-1744
Provider Business Practice Location Address Fax Number:
787-864-6488
Provider Enumeration Date:
04/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CORICA
Authorized Official First Name:
FEDERICO
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-918-1744

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  5528 , 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)





Copyright © 2007-2025 www.npivalidator.com