Provider Demographics
NPI:1740420801
Name:REMAS INDEPENDENT PRACTICE NETWORK, CORP
Entity Type:Organization
Organization Name:REMAS INDEPENDENT PRACTICE NETWORK, CORP
Other - Org Name:
Other - Org Type:
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:MD
Authorized Official - Phone:787-607-3156
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-3910
Mailing Address - Fax:
Practice Address - Street 1:114 CALLE DR SANTIAGO VEVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-3910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization