Provider Demographics
NPI:1467984914
Name:RED DE MEDICOS ASOCIADOS DEL SUR, INC.
Entity Type:Organization
Organization Name:RED DE MEDICOS ASOCIADOS DEL SUR, INC.
Other - Org Name:CENTRO DE VACUNACION REMAS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-267-5829
Mailing Address - Street 1:PO BOX 3060
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:A1 CALLE 65 DE INFANTERIA
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-267-5829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center