Provider Demographics
NPI:1033461421
Name:CLINICA DE SALUD Y PREVENCION DE ANASCO INC
Entity Type:Organization
Organization Name:CLINICA DE SALUD Y PREVENCION DE ANASCO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-805-0707
Mailing Address - Street 1:PO BOX 3286
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3286
Mailing Address - Country:US
Mailing Address - Phone:787-805-0707
Mailing Address - Fax:787-652-4795
Practice Address - Street 1:ESQUINA IBANEZ 14
Practice Address - Street 2:CALLE SAN ANTONIO
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-805-0707
Practice Address - Fax:787-652-4795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty