1689383853 NPI number — CENTRO TERAPEUTICO TERTULIA INC

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 1689383853 NPI number — CENTRO TERAPEUTICO TERTULIA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO TERAPEUTICO TERTULIA INC
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:
1689383853
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00602-1102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB LAS AMERICAS
Provider Second Line Business Practice Location Address:
975 CALLE SANTO DOMINGO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-258-9989
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/16/2022

Additional Information

Authorized Official

Authorized Official Last Name:
COLON
Authorized Official First Name:
LISMARY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
939-258-9989

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com