1861428096 NPI number — CLINICA DE REHABILITACION AUDITIVA AUDIOFONOS PSC

Table of content: (NPI 1861428096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861428096 NPI number — CLINICA DE REHABILITACION AUDITIVA AUDIOFONOS PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICA DE REHABILITACION AUDITIVA AUDIOFONOS PSC
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:
1861428096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. SANTA ROSA
Provider Second Line Business Mailing Address:
CARR. 174 BLOQUE 21-27
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959-5908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-740-4444
Provider Business Mailing Address Fax Number:
787-740-4440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB. SANTA ROSA
Provider Second Line Business Practice Location Address:
CARR. 174 BLOQUE 21-27
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:
787-740-4444
Provider Business Practice Location Address Fax Number:
787-740-4440
Provider Enumeration Date:
06/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADAMES
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-740-4444

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  559, 560 , 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)

  • Identifier: HC396A . This is a "PTAN/OSCAR/LEGACY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".