1952584997 NPI number — SARA E VICENTE BS MT ASCP

Table of content: SARA E VICENTE BS MT ASCP (NPI 1952584997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952584997 NPI number — SARA E VICENTE BS MT ASCP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VICENTE
Provider First Name:
SARA
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BS MT ASCP
Provider Gender Code:
F

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:
1952584997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB ESTANCIAS DE YAUCO H2 CALLE TURQUESA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-267-4407
Provider Business Mailing Address Fax Number:
787-267-1202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR #127 KM 03 BO SUSUA BAJA
Provider Second Line Business Practice Location Address:
SECTOR 4 CALLES SOLAR #1
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-267-4407
Provider Business Practice Location Address Fax Number:
787-267-1202
Provider Enumeration Date:
12/13/2007

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: 291U00000X , 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)