1811395395 NPI number — ISLOTE MEDICAL SOLUTIONS CORPORATION

Table of content: (NPI 1811395395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811395395 NPI number — ISLOTE MEDICAL SOLUTIONS CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ISLOTE MEDICAL SOLUTIONS CORPORATION
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:
1811395395
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CARR 681 # KM4.4
Provider Second Line Business Mailing Address:
BO. ISLOTE
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00612-5313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-881-5073
Provider Business Mailing Address Fax Number:
787-878-0948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 681 KM 4.4
Provider Second Line Business Practice Location Address:
BARRIO ISLOTE
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-0948
Provider Business Practice Location Address Fax Number:
787-881-5073
Provider Enumeration Date:
12/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
GILBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
787-636-5443

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  CB-0712 , 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)





Copyright © 2007-2025 www.npivalidator.com