Provider Demographics
NPI:1760455109
Name:ADMINISTRACION DE SERVICIOS MEDICOS DE PUERTO RICO
Entity Type:Organization
Organization Name:ADMINISTRACION DE SERVICIOS MEDICOS DE PUERTO RICO
Other - Org Name:ASEM
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:RIUS
Authorized Official - Last Name:ARMENDARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-777-3483
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-2129
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-777-3481
Practice Address - Street 1:BO MONACILLOS
Practice Address - Street 2:CARR NO 22 RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-2129
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400127Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO