1841632718 NPI number — ADVANCED ENDOCRINOLOGY CENTER, P.S.C.

Table of content: (NPI 1841632718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841632718 NPI number — ADVANCED ENDOCRINOLOGY CENTER, P.S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ENDOCRINOLOGY CENTER, 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:
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:
1841632718
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1995 ST. # 2 SUITE. 1610
Provider Second Line Business Mailing Address:
METRO MEDICAL CENTER
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959-1610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-527-9896
Provider Business Mailing Address Fax Number:
787-765-9183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ST. # 2 KM 12.3 HNAS. DAVILA
Provider Second Line Business Practice Location Address:
METRO MEDICAL CENTER OFF. A-610
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-527-9896
Provider Business Practice Location Address Fax Number:
787-765-9183
Provider Enumeration Date:
07/22/2013

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ-ROSARIO
Authorized Official First Name:
RAFAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-506-1129

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  17069 , 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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