Provider Demographics
NPI:1891310843
Name:ASOCIACION DE MEDICOS DE PUERTO RICO MS INC
Entity Type:Organization
Organization Name:ASOCIACION DE MEDICOS DE PUERTO RICO MS INC
Other - Org Name:ASOCIACION DE MEDICOS DE PUERTO RICO MS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MERVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-314-6825
Mailing Address - Street 1:URB MONTE CLARO MA-36
Mailing Address - Street 2:PLAZA 7
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-658-6218
Mailing Address - Fax:787-658-7116
Practice Address - Street 1:B11 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6955
Practice Address - Country:US
Practice Address - Phone:787-658-6218
Practice Address - Fax:787-658-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization