1851167928 NPI number — MRS. ARIANNA NOEMI GUADALUPE MAESTRIA

Table of content: MRS. ARIANNA NOEMI GUADALUPE MAESTRIA (NPI 1851167928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851167928 NPI number — MRS. ARIANNA NOEMI GUADALUPE MAESTRIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUADALUPE
Provider First Name:
ARIANNA
Provider Middle Name:
NOEMI
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MAESTRIA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRUZ
Provider Other First Name:
ARIANNA
Provider Other Middle Name:
GUADALUPE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MAESTRIA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1851167928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CONDOMINIO PASEO ESMERALDA
Provider Second Line Business Mailing Address:
112 CALLE 21 APT 12102
Provider Business Mailing Address City Name:
FAJARDO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-486-3200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CONDOMINIO PASEO ESMERALDA
Provider Second Line Business Practice Location Address:
112 CALLE 21 APT 12102
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-486-3200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2023

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: 1041C0700X , with the licence number:  14300 , 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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