1811068497 NPI number — DR. HECTOR JAVIER VILLARRUBIA M.D.

Table of content: (NPI 1609028653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811068497 NPI number — DR. HECTOR JAVIER VILLARRUBIA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VILLARRUBIA
Provider First Name:
HECTOR
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1811068497
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 458
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:
00960-0458
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-640-7597
Provider Business Mailing Address Fax Number:
787-786-3653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 CALLE SANTA CRUZ SUITE 312
Provider Second Line Business Practice Location Address:
EDIFICIO MEDICO SANTA CRUZ
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-786-3652
Provider Business Practice Location Address Fax Number:
787-786-3653
Provider Enumeration Date:
11/13/2006

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: 207W00000X , with the licence number:  M4623 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 16466 , 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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