1811003692 NPI number — DR. ANGEL ROBERTO ALMODOVAR MD

Table of content: KAJAL PATEL (NPI 1245704790)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811003692 NPI number — DR. ANGEL ROBERTO ALMODOVAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALMODOVAR
Provider First Name:
ANGEL
Provider Middle Name:
ROBERTO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALMODOVAR
Provider Other First Name:
ANGEL
Provider Other Middle Name:
ROBERTO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1811003692
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7128
Provider Second Line Business Mailing Address:
MIGRANT HEALTH CENTER, INC.
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-7128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-805-2900
Provider Business Mailing Address Fax Number:
787-834-1924

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE RAMON EMETERIO BETANCES 392 SUR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-805-2900
Provider Business Practice Location Address Fax Number:
787-834-1924
Provider Enumeration Date:
08/22/2006

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: 207V00000X , with the licence number:  3932 , 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: 2526 . This is a "AMPR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660427801 . This is a "CIGNA PREFERRED" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 062611 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25367 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25367 . This is a "MEDICARE OPTIMO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2231T . This is a "PMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25367 . This is a "MEDICARE SELECTO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660427801 . This is a "CIGNA EXCLUSIVE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660427801BI . This is a "MCS CLASSICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: SH7801 . This is a "UIA PROVIDER NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 209206 . This is a "PREFERRED HEALTH PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660427801 . This is a "MAPFRE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6800036 . This is a "HUMANA PROVIDER NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 112215014 . This is a "MCS HMO PROVIDER NUM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660427801 . This is a "COSVIMED PROVIDER NUM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 660427801B1 . This is a "MCS PROVIDER NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7082 . This is a "FIRST MEDICAL PROVIDER NU" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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