1598101834 NPI number — SERVICIOS MEDICOS GINECOLOGICOS CRL

Table of content: JON CHRISTOPHER RASAK MD (NPI 1376524371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598101834 NPI number — SERVICIOS MEDICOS GINECOLOGICOS CRL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERVICIOS MEDICOS GINECOLOGICOS CRL
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:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1598101834
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 128
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-0128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-616-5900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VERSALLES REINA DEL SOL 2314
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00682
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-616-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
FERRER
Authorized Official First Name:
SONIA
Authorized Official Middle Name:
I
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-616-5900

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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