1659758340 NPI number — SERVICIOS DE SALUD INTEGRADOS, P.S.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659758340 NPI number — SERVICIOS DE SALUD INTEGRADOS, P.S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERVICIOS DE SALUD INTEGRADOS, P.S.C.
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:
1659758340
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
714 MAR MEDITERRANEO
Provider Second Line Business Mailing Address:
PASEO LOS CORALES II
Provider Business Mailing Address City Name:
DORADO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00646-6426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-253-4080
Provider Business Mailing Address Fax Number:
787-710-9878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 AVE LAGUNA STE 207
Provider Second Line Business Practice Location Address:
LAGUNA SHOPPING CENTER
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00979-6426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-253-4080
Provider Business Practice Location Address Fax Number:
787-710-9878
Provider Enumeration Date:
05/01/2015

Additional Information

Authorized Official

Authorized Official Last Name:
GIRON MOREL
Authorized Official First Name:
JESSIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-253-4080

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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