1730207457 NPI number — JORGE LUIS VALENTIN M.D.

Table of content: MS. MELANIE K VIRGILIO FNP-BC (NPI 1346707759)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730207457 NPI number — JORGE LUIS VALENTIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALENTIN
Provider First Name:
JORGE
Provider Middle Name:
LUIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1730207457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
351 AVE HOSTOS
Provider Second Line Business Mailing Address:
MEDICAL EMPORIUM 308
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00680-1502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-316-1479
Provider Business Mailing Address Fax Number:
787-408-4844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
351 AVE HOSTOS
Provider Second Line Business Practice Location Address:
MEDICAL EMPORIUM 308
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-316-1479
Provider Business Practice Location Address Fax Number:
787-408-4844
Provider Enumeration Date:
03/27/2007

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: 2084P0800X , with the licence number:  9342 , 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: 26-0273-3 . This is a "ACAA (STATE AUTO ACC INS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 54-09342 . This is a "UIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 127 . This is a "HUMANA INS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 14-9342 . This is a "MCS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 03862 . This is a "AMERICAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 127 . This is a "HUMANA HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 82573 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 5471 . This is a "PREFFERED HEALTH MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 148110 . This is a "VALUE OPTIONS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1934 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 222147 . This is a "TRIPLE S MEDICARE OPTIONS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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