1881949790 NPI number — JEY ROMERO TOSADO

Table of content: JEY ROMERO TOSADO (NPI 1881949790)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881949790 NPI number — JEY ROMERO TOSADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMERO TOSADO
Provider First Name:
JEY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1881949790
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 620
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VEGA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00694-0620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-313-8344
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 2 KM 42.5
Provider Second Line Business Practice Location Address:
BO ALGARROBO
Provider Business Practice Location Address City Name:
VEGA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-313-8344
Provider Business Practice Location Address Fax Number:
787-621-4025
Provider Enumeration Date:
07/17/2012

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: 103TC0700X , with the licence number:  4334 , 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: 4292902 . This is a "DRIVER'S LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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