1912129693 NPI number — ALLAN SAUNDERS-MALAVE MD

Table of content: ALLAN SAUNDERS-MALAVE MD (NPI 1912129693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912129693 NPI number — ALLAN SAUNDERS-MALAVE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUNDERS-MALAVE
Provider First Name:
ALLAN
Provider Middle Name:
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:
1912129693
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
E-9 CAMINO DE LAS PALMAS
Provider Second Line Business Mailing Address:
URB PASEO DEL PRADO
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-233-8700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DOCTOR CENTER'S HOSPITAL DE BAYAMON
Provider Second Line Business Practice Location Address:
DEPT DE RADIOLOGIA INTERVENCIONAL
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-622-5420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2007

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: 2085R0202X , with the licence number:  054936 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X , with the licence number: 29795 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 297958 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 17,526 . This is a "LICENCIA DE MEDICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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