1578606570 NPI number — ANTONIA ARIAS LOT

Table of content: ANTONIA ARIAS LOT (NPI 1578606570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578606570 NPI number — ANTONIA ARIAS LOT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARIAS
Provider First Name:
ANTONIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LOT
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:
1578606570
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 43001
Provider Second Line Business Mailing Address:
SUITE 217-A
Provider Business Mailing Address City Name:
RIO GRANDE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00745-6600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-530-9597
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE AQUAMARINA
Provider Second Line Business Practice Location Address:
66, VILLA BLANCA
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-1944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-743-3385
Provider Business Practice Location Address Fax Number:
787-743-1030
Provider Enumeration Date:
02/15/2007

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: 225X00000X , with the licence number:  1052 , 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: 06271 . This is a "OCUPATIONAL THERAPY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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