1790023315 NPI number — MS. SUHAILLY LA TORRE TORO CONSEJERIA SUSTANCIA

Table of content: MS. SUHAILLY LA TORRE TORO CONSEJERIA SUSTANCIA (NPI 1790023315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790023315 NPI number — MS. SUHAILLY LA TORRE TORO CONSEJERIA SUSTANCIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LA TORRE TORO
Provider First Name:
SUHAILLY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CONSEJERIA SUSTANCIA
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:
1790023315
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE TAMESIS CASA J 5
Provider Second Line Business Mailing Address:
URBANIZACION ESTANCIAS DE MONTE GRANDE
Provider Business Mailing Address City Name:
CABO ROJO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-951-8705
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE TAMESIS CASA J 5
Provider Second Line Business Practice Location Address:
URBANIZACION ESTANCIAS DE MONTE GRANDE
Provider Business Practice Location Address City Name:
CABO ROJO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-951-8705
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2013

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: 101YA0400X , with the licence number:  0340 , 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)





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