1932206109 NPI number — HECTOR I. ROSADO

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 1932206109 NPI number — HECTOR I. ROSADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HECTOR I. ROSADO
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:
6
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:
1932206109
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6617
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-5617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-348-8682
Provider Business Mailing Address Fax Number:
787-797-8682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
E12C CALLE 1
Provider Second Line Business Practice Location Address:
BELLA VISTA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00957-6008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-348-8682
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROSADO
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
IVAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-348-8682

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  TC AMB 293 , 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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