Provider Demographics
NPI:1144058637
Name:AXTMAYER MD LLC
Entity type:Organization
Organization Name:AXTMAYER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:AXTMAYER CARCACHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-361-7751
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-0880
Mailing Address - Country:US
Mailing Address - Phone:787-361-7751
Mailing Address - Fax:
Practice Address - Street 1:CARR 14, INTERIOR, BARRIO RINCON, SECTOR
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty