1972758076 NPI number — CENTRO DE DIAGNOSTICO Y TRATAMIENTO LAS PIEDRAS

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 1972758076 NPI number — CENTRO DE DIAGNOSTICO Y TRATAMIENTO LAS PIEDRAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO DE DIAGNOSTICO Y TRATAMIENTO LAS PIEDRAS
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:
1972758076
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CARR.198 KM 22.2
Provider Second Line Business Mailing Address:
SECTOR PARQUE INDUSTRIAL
Provider Business Mailing Address City Name:
LAS PIEDRAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-733-8969
Provider Business Mailing Address Fax Number:
787-716-0055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 198 KM 22.2
Provider Second Line Business Practice Location Address:
SECTOR PARQUE INDUSTRIAL
Provider Business Practice Location Address City Name:
LAS PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-733-8969
Provider Business Practice Location Address Fax Number:
787-716-0055
Provider Enumeration Date:
11/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
DIRECTORA EJECUTIVA
Authorized Official Telephone Number:
787-771-2100

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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