Provider Demographics
NPI:1215022520
Name:MAS MEDICAL DIAGNOSTIC.CORP
Entity Type:Organization
Organization Name:MAS MEDICAL DIAGNOSTIC.CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-649-6388
Mailing Address - Street 1:1311 AVE PONCE DE LEON
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-4037
Mailing Address - Country:US
Mailing Address - Phone:787-649-6388
Mailing Address - Fax:787-723-1369
Practice Address - Street 1:1311 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 303
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-4037
Practice Address - Country:US
Practice Address - Phone:787-649-6388
Practice Address - Fax:787-723-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4545246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty