1861436461 NPI number — ERNESTO J MUNOZ VILCHES MD

Table of content: ERNESTO J MUNOZ VILCHES MD (NPI 1861436461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861436461 NPI number — ERNESTO J MUNOZ VILCHES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUNOZ VILCHES
Provider First Name:
ERNESTO
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1861436461
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
55 CALLE DE LA FIDELIDAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725-1844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-630-4060
Provider Business Mailing Address Fax Number:
787-721-8448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 CALLE WASHINGTON SUITE 208B
Provider Second Line Business Practice Location Address:
ASHFORD MEDICAL CENTER
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-1561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-721-4836
Provider Business Practice Location Address Fax Number:
787-721-8448
Provider Enumeration Date:
06/15/2006

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: 207R00000X , with the licence number:  11412 , 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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