Provider Demographics
NPI:1568516201
Name:M&P CARE AT HOME CSP
Entity Type:Organization
Organization Name:M&P CARE AT HOME CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-276-5355
Mailing Address - Street 1:PO BOX 6578
Mailing Address - Street 2:LOIZA STATE STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00914-6578
Mailing Address - Country:US
Mailing Address - Phone:787-276-5355
Mailing Address - Fax:
Practice Address - Street 1:611 CALLE MANUEL PAVIA
Practice Address - Street 2:STE 213
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00910
Practice Address - Country:US
Practice Address - Phone:787-276-5355
Practice Address - Fax:787-722-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7326OtherAMERICAN HEALTH MEDICARE
PR57715OtherTRIPLE S OPTIMO
PR57715OtherTRIPLE S
PR601439OtherMEDICARE Y MUCHO MAS
PR57715OtherTRIPLE S
PR57715OtherTRIPLE S OPTIMO
PR0084704Medicare ID - Type UnspecifiedMEDICARE