Provider Demographics
NPI:1871859793
Name:ASSMCA
Entity Type:Organization
Organization Name:ASSMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENFERMERO GENERALISTA
Authorized Official - Prefix:MR
Authorized Official - First Name:DIAZ
Authorized Official - Middle Name:MUJICA
Authorized Official - Last Name:ANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-995-5200
Mailing Address - Street 1:GLADIOLA 7B
Mailing Address - Street 2:CIUDAD JARDIN
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-637-4414
Mailing Address - Fax:
Practice Address - Street 1:GLADIOLA 7B
Practice Address - Street 2:CIUDAD JARDIN
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-637-4414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health