1891359329 NPI number — DRA DAMARYS GONZALEZ GALICIA PSC

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 1891359329 NPI number — DRA DAMARYS GONZALEZ GALICIA PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRA DAMARYS GONZALEZ GALICIA 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:
1891359329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1586
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00602-1586
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-477-0342
Provider Business Mailing Address Fax Number:
787-658-6102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 417 KM 4.2
Provider Second Line Business Practice Location Address:
BO MAMEY
Provider Business Practice Location Address City Name:
AGUADA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00602-0060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-477-0342
Provider Business Practice Location Address Fax Number:
787-658-6102
Provider Enumeration Date:
04/30/2019

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
DAMARYS
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
787-477-0342

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com