1841584224 NPI number — CENTRO DE MEDICINA PRIMARIA Y PREVENTIVA DEL DR CRISTOBAL MENDEZ, INC.

Table of content: (NPI 1841584224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841584224 NPI number — CENTRO DE MEDICINA PRIMARIA Y PREVENTIVA DEL DR CRISTOBAL MENDEZ, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO DE MEDICINA PRIMARIA Y PREVENTIVA DEL DR CRISTOBAL MENDEZ, INC.
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:
1841584224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 01 BOX 11465
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN SEBASTIAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00685-9770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-896-5738
Provider Business Mailing Address Fax Number:
787-896-5738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BARRIO AIBONITO GUERRERO CARR 447 KM 3.7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN SEBASTIAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00685-9770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-896-5738
Provider Business Practice Location Address Fax Number:
787-896-5738
Provider Enumeration Date:
06/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MENDEZ RUIZ
Authorized Official First Name:
CRISTOBAL
Authorized Official Middle Name:
IVAN
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-896-5738

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  16796 , 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