1871854588 NPI number — REGALADO DIMAZANA CALAPATIA II RPT

Table of content: REGALADO DIMAZANA CALAPATIA II RPT (NPI 1871854588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871854588 NPI number — REGALADO DIMAZANA CALAPATIA II RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALAPATIA
Provider First Name:
REGALADO
Provider Middle Name:
DIMAZANA
Provider Name Prefix Text:
Provider Name Suffix Text:
II
Provider Credential Text:
RPT
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:
1871854588
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1580 SAGRASS CORPORATE PARKWAY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SUNRISE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33323-2860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-257-6894
Provider Business Mailing Address Fax Number:
866-422-6431

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1580 SAWGRASS CORP PKWY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SUNRISE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33323-2860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-257-6894
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2012

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: 225100000X , with the licence number:  070019059 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com