1649733395 NPI number — KATERINA EDITH TORO

Table of content: KATERINA EDITH TORO (NPI 1649733395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649733395 NPI number — KATERINA EDITH TORO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORO
Provider First Name:
KATERINA
Provider Middle Name:
EDITH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1649733395
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 9 BOX 59196
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:
00725-9243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-653-5800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO LA BARRA K30 H5
Provider Second Line Business Practice Location Address:
119F
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-0072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-745-0340
Provider Business Practice Location Address Fax Number:
787-746-1780
Provider Enumeration Date:
04/10/2019

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: 104100000X , with the licence number:  17006 , 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: 4777140 . This is a "DRIVERS LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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