1730738675 NPI number — CARIBBEAN SHOULDER AND ELBOW INSTITUTE

Table of content: (NPI 1730738675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730738675 NPI number — CARIBBEAN SHOULDER AND ELBOW INSTITUTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN SHOULDER AND ELBOW INSTITUTE
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:
1730738675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
710 CALLE UN APT 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00907-4238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-955-3331
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 1 MARGINAL CARR#2
Provider Second Line Business Practice Location Address:
LOCAL ESQUINA 3-B
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-622-5420
Provider Business Practice Location Address Fax Number:
787-625-2490
Provider Enumeration Date:
09/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ DIAZ
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-955-3331

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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