1477781292 NPI number — MEDICAL EPILEPSY CARE PSC

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 1477781292 NPI number — MEDICAL EPILEPSY CARE PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL EPILEPSY CARE PSC
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:
1477781292
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LA VILLA DE TORRIMAR
Provider Second Line Business Mailing Address:
CALLE REY FRANCISCO 332
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-751-2509
Provider Business Mailing Address Fax Number:
787-781-5307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 AVE SAN PATRICIO SUITE 1270
Provider Second Line Business Practice Location Address:
EDF MARAMAR PLAZA
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-751-2509
Provider Business Practice Location Address Fax Number:
787-781-5307
Provider Enumeration Date:
07/01/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PITA GARCIA
Authorized Official First Name:
IGNACIO
Authorized Official Middle Name:
L
Authorized Official Title or Position:
MEDICO
Authorized Official Telephone Number:
787-948-2231

Provider Taxonomy Codes

  • Taxonomy code: 2084N0600X , with the licence number:  14,434 , 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)

  • Identifier: 14,434 . This is a "LIC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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