Provider Demographics
NPI:1821558636
Name:EBATEC
Entity Type:Organization
Organization Name:EBATEC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-367-3974
Mailing Address - Street 1:1018 AVE ASHFORD APTO 11
Mailing Address - Street 2:ASTOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907
Mailing Address - Country:US
Mailing Address - Phone:787-367-3974
Mailing Address - Fax:
Practice Address - Street 1:40 GAUTIE BENITEZ CAGUAS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-367-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR66081862OtherCOMERCIAL INSURANCE