1982710117 NPI number — LUIS ALEXANDER FRIAS

Table of content: LUIS ALEXANDER FRIAS (NPI 1982710117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982710117 NPI number — LUIS ALEXANDER FRIAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIAS
Provider First Name:
LUIS
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1982710117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
D3 COAKLEY BAY CONDOMINIUM
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHRISTIANSTED
Provider Business Mailing Address State Name:
VI
Provider Business Mailing Address Postal Code:
00820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-306-7821
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ESTATE CANE STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERIKSTED
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00840-4425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-773-0007
Provider Business Practice Location Address Fax Number:
340-772-5755
Provider Enumeration Date:
08/21/2006

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: 2084N0400X , with the licence number:  13391 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0600X , with the licence number: 2118 , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0600X , with the licence number: N3651 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0600X , with the licence number: 13391 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X , with the licence number: 2118 , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 601915 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6830050 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1301918 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 13391 . This is a "SSBV" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 90325 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 061782 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 13391 . This is a "DEPT. OF VETERANS AFFAIRS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".