Provider Demographics
NPI:1316906175
Name:SIGNET PUERTO RICO
Entity type:Organization
Organization Name:SIGNET PUERTO RICO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUFFRONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-757-5985
Mailing Address - Street 1:PO BOX 3457
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3457
Mailing Address - Country:US
Mailing Address - Phone:787-757-5985
Mailing Address - Fax:787-776-0353
Practice Address - Street 1:AVE MONSERRATE AC-8 VALLE ARRIBA HEIGHTS
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-757-5985
Practice Address - Fax:787-776-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR137519207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty