1669164828 NPI number — CONSULT MEDICAL PR TRAINING CENTER

Table of content: (NPI 1669164828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669164828 NPI number — CONSULT MEDICAL PR TRAINING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONSULT MEDICAL PR TRAINING CENTER
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:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1669164828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PMB 291 PO BOX 1283
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN LORENZO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00754
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO TOMAS DE CASTRO CARR 183 KM 5.0
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-217-5205
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2023

Additional Information

Authorized Official

Authorized Official Last Name:
COLON
Authorized Official First Name:
KAROL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-217-5205

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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