1679523138 NPI number — GASPAR R GARCIA MD

Table of content: GASPAR R GARCIA MD (NPI 1679523138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679523138 NPI number — GASPAR R GARCIA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
GASPAR
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1679523138
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1507 AVE PONCE DE LEON
Provider Second Line Business Mailing Address:
PMB 359
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00909-1750
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-263-0644
Provider Business Mailing Address Fax Number:
785-535-1024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO RINCON SECT LAS LOMAS CARR 14 KM 72.2
Provider Second Line Business Practice Location Address:
EDIFICIO PROFESSIONAL HOSPITAL MENONITA
Provider Business Practice Location Address City Name:
CAYEY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-263-0644
Provider Business Practice Location Address Fax Number:
787-535-1024
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: 2085R0202X , with the licence number:  13190 , 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: 7360033 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com