1871835504 NPI number — DR. JUAN F. RODRIGUEZ ACOSTA, PSC

Table of content: DR. GURRINDER SINGH ATWAL DDS (NPI 1598827859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871835504 NPI number — DR. JUAN F. RODRIGUEZ ACOSTA, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. JUAN F. RODRIGUEZ ACOSTA, 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:
1871835504
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2225 PONCE BYP STE 904
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00717-1381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-849-5300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB. EL MONTE 3659, CALLE CUMBRE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-640-2163
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
939-640-2163

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  008238 , 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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