Provider Demographics
NPI:1700024403
Name:FACILIDADES MEDICAS ASOCIADAS CORP.
Entity Type:Organization
Organization Name:FACILIDADES MEDICAS ASOCIADAS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-850-1858
Mailing Address - Street 1:59W CALLE DUFRESNE W
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3609
Mailing Address - Country:US
Mailing Address - Phone:787-285-0655
Mailing Address - Fax:787-285-4060
Practice Address - Street 1:150 AVE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3372
Practice Address - Country:US
Practice Address - Phone:787-285-0655
Practice Address - Fax:787-285-4060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization