1699944090 NPI number — MS. MARIA LOUISA CRESPO MT(ASCP)

Table of content: MS. MARIA LOUISA CRESPO MT(ASCP) (NPI 1699944090)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699944090 NPI number — MS. MARIA LOUISA CRESPO MT(ASCP)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRESPO
Provider First Name:
MARIA
Provider Middle Name:
LOUISA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MT(ASCP)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BACTERIOLOGICO SAN ANTONIO
Provider Other First Name:
LABORATORIO
Provider Other Middle Name:
CLINICO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1699944090
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 791
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00690-0791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-890-6161
Provider Business Mailing Address Fax Number:
787-890-6161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1065 AVE GENERAL RAMEY
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00690-1117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-890-6161
Provider Business Practice Location Address Fax Number:
787-890-6161
Provider Enumeration Date:
02/29/2008

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: 291U00000X , with the licence number:  761 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 246QM0706X , with the licence number: 2870 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 051502 . This is a "BLUE CROSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 800386 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: LA 0179 . This is a "PAN AMERICAN LIFE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 5599 . This is a "AMERICAN HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6030045 . This is a "HUMANA HEALTH INS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 0152 . This is a "INTERNATIONAL MEDICAL CARD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30731 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: A0170 . This is a "FIRST PLUS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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