1821021213 NPI number — EQUIPO GINECOLOGICO Y OBSTETRICO DE SALUD,P.S.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821021213 NPI number — EQUIPO GINECOLOGICO Y OBSTETRICO DE SALUD,P.S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EQUIPO GINECOLOGICO Y OBSTETRICO DE SALUD,P.S.C.
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:
6
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:
1821021213
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
158 CALLE FONT MARTELO
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUMACAO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00791-3337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-852-3560
Provider Business Mailing Address Fax Number:
787-852-3538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
66 AVE DEGETAU APT 500
Provider Second Line Business Practice Location Address:
HIMA PLAZA I SUITE 505
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-5844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-744-5414
Provider Business Practice Location Address Fax Number:
787-258-4587
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NAVAS MICHEO
Authorized Official First Name:
MANUEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-744-5414

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 67906 . This is a "LA CRUZ AZUL DE PUERTO RI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 89732 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: PE1198 . This is a "PAN AMERICAN LIFE INS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6610095 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 2501 . This is a "INTERNATIONAL MEDICAL CAR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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