1750889812 NPI number — UNIVERSIDAD CENTRAL DEL CARIBE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750889812 NPI number — UNIVERSIDAD CENTRAL DEL CARIBE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSIDAD CENTRAL DEL CARIBE, INC.
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:
1750889812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 60327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-6032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-269-0988
Provider Business Mailing Address Fax Number:
787-966-7923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 AVE LAUREL
Provider Second Line Business Practice Location Address:
ESQUINA BELLISIMA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956-3268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-269-0988
Provider Business Practice Location Address Fax Number:
787-966-7923
Provider Enumeration Date:
01/24/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CASAS
Authorized Official First Name:
INGRID
Authorized Official Middle Name:
Authorized Official Title or Position:
CHILD AND ADOLESCENT PSYCHIATRY
Authorized Official Telephone Number:
787-269-0988

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  14873 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0804X , with the licence number: 14873 , 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: 1255495412 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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