1912043852 NPI number — EQUIPOS MEDICOS DE LARES, INC.

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 1912043852 NPI number — EQUIPOS MEDICOS DE LARES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EQUIPOS MEDICOS DE LARES, INC.
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:
1912043852
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 369
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LARES
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00669-0369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-897-6969
Provider Business Mailing Address Fax Number:
787-897-6797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 129 KM 22.8
Provider Second Line Business Practice Location Address:
BO. CALLEJONES
Provider Business Practice Location Address City Name:
LARES
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-897-6969
Provider Business Practice Location Address Fax Number:
787-897-6797
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARIAS
Authorized Official First Name:
IVETTE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
GENERAL MANAGER
Authorized Official Telephone Number:
787-897-6969

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , 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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