Provider Demographics
NPI:1184686966
Name:MEDICAL CARE SPECIALISTS CORP.
Entity Type:Organization
Organization Name:MEDICAL CARE SPECIALISTS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEREZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-706-8125
Mailing Address - Street 1:1462 CALLE EDEN
Mailing Address - Street 2:CAPARRA HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-706-8125
Mailing Address - Fax:787-706-8220
Practice Address - Street 1:CONSTITUCION 403
Practice Address - Street 2:PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-0000
Practice Address - Country:US
Practice Address - Phone:787-781-8318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5366430001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5-7346-MEOtherTRIPLE S PROVIDER
PR5366430001Medicare NSC