Provider Demographics
NPI:1144609249
Name:SV NEUMOLOGY PSC
Entity Type:Organization
Organization Name:SV NEUMOLOGY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-579-5096
Mailing Address - Street 1:AVENIDA JUAN MARTINEZ 14 CONDOMINIO MALAGA PARK
Mailing Address - Street 2:NUMBER 77
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-579-5096
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA JUAN MARTINEZ 14 CONDOMINIO MALAGA PARK
Practice Address - Street 2:NUMBER 77
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971
Practice Address - Country:US
Practice Address - Phone:787-579-5096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR338280OtherREGISTRY