1528018124 NPI number — NILDALIZ ANDREWS M.D.

Table of content: NILDALIZ ANDREWS M.D. (NPI 1528018124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528018124 NPI number — NILDALIZ ANDREWS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDREWS
Provider First Name:
NILDALIZ
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1528018124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N19 CALLE 14
Provider Second Line Business Mailing Address:
LAGOS DE PLATA
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00949-3233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-249-8644
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
N19 CALLE 14
Provider Second Line Business Practice Location Address:
LAGOS DE PLATA
Provider Business Practice Location Address City Name:
TOA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00949-3233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-249-8644
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2006

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: 208D00000X , with the licence number:  15418 , 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: 01-2307-2 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 31-15418 . This is a "UIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 500489E . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9570028 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 212905 . This is a "PREFERRED" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com