Provider Demographics
NPI:1609958446
Name:SOCIEDAD DE SERVICIOS NEONATALES DE ARECIBO
Entity Type:Organization
Organization Name:SOCIEDAD DE SERVICIOS NEONATALES DE ARECIBO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASISTAND ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JINEAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-880-6263
Mailing Address - Street 1:PO BOX 141418
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:US
Mailing Address - Phone:787-880-6263
Mailing Address - Fax:787-880-6263
Practice Address - Street 1:AVENIDA SAN LUIS CARR 129 KM1
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-878-7272
Practice Address - Fax:787-878-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-04-20
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-09-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherNUMERO PATRONAL