1770027054 NPI number — VALERIE CARRION

Table of content: VALERIE CARRION (NPI 1770027054)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770027054 NPI number — VALERIE CARRION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARRION
Provider First Name:
VALERIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1770027054
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CARR 183 KM 1 BO HATO
Provider Second Line Business Mailing Address:
SAN LORENZO SHOPPING CENTER
Provider Business Mailing Address City Name:
SAN LORENZO
Provider Business Mailing Address State Name:
PUERTO RICO
Provider Business Mailing Address Postal Code:
00754
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
939-243-7470
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 183 KM 1 BO HATO
Provider Second Line Business Practice Location Address:
SAN LORENZO SHOPPING CENTER
Provider Business Practice Location Address City Name:
SAN LORENZO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-715-1770
Provider Business Practice Location Address Fax Number:
787-715-1771
Provider Enumeration Date:
12/06/2016

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: 183700000X , with the licence number:  8441 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183700000X , with the licence number: 255682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1215250238 . This is a "PHARMACY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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