1740397439 NPI number — MRS. ELSA NIEVES SOTO RPT, MPT

Table of content: MRS. ELSA NIEVES SOTO RPT, MPT (NPI 1740397439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740397439 NPI number — MRS. ELSA NIEVES SOTO RPT, MPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIEVES SOTO
Provider First Name:
ELSA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPT, MPT
Provider Gender Code:
F

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:
1740397439
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 144036
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00614-4036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-235-7516
Provider Business Mailing Address Fax Number:
787-881-5572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 2 KM 62.8
Provider Second Line Business Practice Location Address:
SECTOR CANDELARIA
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-235-7516
Provider Business Practice Location Address Fax Number:
787-881-5572
Provider Enumeration Date:
08/25/2006

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: 225100000X , with the licence number:  982 , 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: 51040 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 57142 . This is a "SSS SELECTO / OPTIMO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6120247 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 870090 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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