Provider Demographics
NPI:1689626491
Name:SALVA AYMAT, ERVIN ALFREDO (MD)
Entity Type:Individual
Prefix:
First Name:ERVIN
Middle Name:ALFREDO
Last Name:SALVA AYMAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CALLE KALBERER
Mailing Address - Street 2:RAMEY
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1505
Mailing Address - Country:US
Mailing Address - Phone:787-633-7892
Mailing Address - Fax:787-872-4011
Practice Address - Street 1:7023 AVE AGUSTIN RAMOS CALERO
Practice Address - Street 2:INT 3
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-3445
Practice Address - Country:US
Practice Address - Phone:787-633-7892
Practice Address - Fax:787-872-4011
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13870208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR002-3822Medicare ID - Type UnspecifiedNON-PARTICIPANT
PRI-49327Medicare UPIN