1710275144 NPI number — RECINTO DE CIENCIAS MEDICAS

Table of content: (NPI 1710275144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710275144 NPI number — RECINTO DE CIENCIAS MEDICAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RECINTO DE CIENCIAS MEDICAS
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:
6
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:
1710275144
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29134
Provider Second Line Business Mailing Address:
CENTRO DE ENFERMEDADES HEREDITARIAS DE PR
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00929-0134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-754-9165
Provider Business Mailing Address Fax Number:
787-274-8156

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
OFIC. 563 EDIF. PRINCIPAL RCM
Provider Second Line Business Practice Location Address:
CENTRO MEDICO DE PUERTO RICO
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-754-9165
Provider Business Practice Location Address Fax Number:
787-274-8156
Provider Enumeration Date:
07/19/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
SHAYRA
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
ADM. SECRETARY
Authorized Official Telephone Number:
787-754-9165

Provider Taxonomy Codes

  • Taxonomy code: 207SG0202X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207SG0203X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0201X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0214X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133VN1004X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133VN1006X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163W00000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WP0200X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 164W00000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207SC0300X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207SG0201X , 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: 001 . This is a "PPMI GROUP" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".