1649641820 NPI number — METRO PAVIA HEALTHCARE CENTERS

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 1649641820 NPI number — METRO PAVIA HEALTHCARE CENTERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METRO PAVIA HEALTHCARE CENTERS
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:
METRO PAVIA CLINIC ARECIBO
Provider Other Organization Name Type Code:
3
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:
1649641820
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9976
Provider Second Line Business Mailing Address:
COTTO STATION
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00613-9976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-772-9850
Provider Business Mailing Address Fax Number:
787-274-8895

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ZONA INDUSTRIAL VICTOR ROJAS 2 CARR 129
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-772-9850
Provider Business Practice Location Address Fax Number:
787-274-8895
Provider Enumeration Date:
10/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SOLIVAN
Authorized Official First Name:
VIVIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-234-8865

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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