Provider Demographics
NPI:1265866818
Name:CARIBBEAN MEDICAL MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:CARIBBEAN MEDICAL MANAGEMENT SERVICES LLC
Other - Org Name:CARIBBEAN MEDICAL MANAGEMENT SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOZADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-539-8965
Mailing Address - Street 1:C22 CALLE B
Mailing Address - Street 2:URB MONTELLANO
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4115
Mailing Address - Country:US
Mailing Address - Phone:787-539-8965
Mailing Address - Fax:
Practice Address - Street 1:C22 CALLE B
Practice Address - Street 2:URB MONTELLANO
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4115
Practice Address - Country:US
Practice Address - Phone:787-539-8965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherMEDICAL CONSULTINGAND ADVISER