Provider Demographics
NPI:1679190474
Name:APS CLINICS OF PUERTO RICO, INC.
Entity Type:Organization
Organization Name:APS CLINICS OF PUERTO RICO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REGULATORY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-641-0774
Mailing Address - Street 1:PO BOX 71474
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8574
Mailing Address - Country:US
Mailing Address - Phone:787-641-0774
Mailing Address - Fax:
Practice Address - Street 1:1215 AVE PONCE DE LEON STE 102
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3920
Practice Address - Country:US
Practice Address - Phone:787-641-0773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APS CLINICS OF PUERTO RICO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health