1851630321 NPI number — CENTRO DE CURACION DE HERIDAS DEL CARIBE, INC

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 1851630321 NPI number — CENTRO DE CURACION DE HERIDAS DEL CARIBE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO DE CURACION DE HERIDAS DEL CARIBE, 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:
1851630321
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3881
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00605-3881
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-931-7850
Provider Business Mailing Address Fax Number:
787-931-7940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
#18 SEVERIANO CUEVAS AVE. RT #2 KM 141.1
Provider Second Line Business Practice Location Address:
HOSPITAL BUEN SAMARITANO
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-931-7850
Provider Business Practice Location Address Fax Number:
787-931-7940
Provider Enumeration Date:
02/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
FORTE-MALAVE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-831-7437

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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