1942351812 NPI number — CARIBBEAN PULMONARY CARE, INC

Table of content: (NPI 1942351812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942351812 NPI number — CARIBBEAN PULMONARY CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN PULMONARY CARE, 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:
1942351812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7891
Provider Second Line Business Mailing Address:
PMB 369
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00970-7891
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-304-0446
Provider Business Mailing Address Fax Number:
787-781-3901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
598 CALLE ALDEBARAN STE 101
Provider Second Line Business Practice Location Address:
URB. ALTAMIRA
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-9999
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-304-0446
Provider Business Practice Location Address Fax Number:
787-781-3901
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HERNANDEZ
Authorized Official First Name:
ROBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-304-0446

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 08-P-1385 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 54753 . This is a "TRIPLE-S DE PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 991079 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 50347 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 54753 . This is a "TRIPLE-S OPTIMO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9001772 . This is a "CRUZ AZUL DE PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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