1770658130 NPI number — GLOBAL DIAGNOSTICS, INC

Table of content: (NPI 1770658130)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770658130 NPI number — GLOBAL DIAGNOSTICS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GLOBAL DIAGNOSTICS, 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:
1770658130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1845 CARRETERA #2
Provider Second Line Business Mailing Address:
BAYAMON MEDICAL PLAZA, SUITE 910
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-740-7903
Provider Business Mailing Address Fax Number:
787-779-0754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1845 CARRETERA #2
Provider Second Line Business Practice Location Address:
BAYAMON MEDICAL PLAZA, SUITE 910
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-740-7903
Provider Business Practice Location Address Fax Number:
787-779-0754
Provider Enumeration Date:
11/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MIJANGOS
Authorized Official First Name:
MARIO
Authorized Official Middle Name:
E
Authorized Official Title or Position:
EXECUTIVE DIRECTOR & COO
Authorized Official Telephone Number:
407-466-1332

Provider Taxonomy Codes

  • Taxonomy code: 246Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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