1952443400 NPI number — MR. JOSE ANGEL JAIME LPN

Table of content: MR. JOSE ANGEL JAIME LPN (NPI 1952443400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952443400 NPI number — MR. JOSE ANGEL JAIME LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAIME
Provider First Name:
JOSE
Provider Middle Name:
ANGEL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPN
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:
1952443400
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CMR 442 BOX 798
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEIDELBERG
Provider Business Mailing Address State Name:
APO
Provider Business Mailing Address Postal Code:
AE 09042
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
3712969
Provider Business Mailing Address Fax Number:
3712320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CMR 442 BOX 798
Provider Second Line Business Practice Location Address:
PACU
Provider Business Practice Location Address City Name:
HEIDELBERG
Provider Business Practice Location Address State Name:
APO
Provider Business Practice Location Address Postal Code:
AE 09042
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
3712969
Provider Business Practice Location Address Fax Number:
3712320
Provider Enumeration Date:
02/13/2007

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: 164W00000X , with the licence number:  PN1215851 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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