Provider Demographics
NPI:1922288232
Name:DRA MARIA R COMAS, CSP
Entity Type:Organization
Organization Name:DRA MARIA R COMAS, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:COMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-882-3359
Mailing Address - Street 1:PO BOX 1038
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-882-3359
Mailing Address - Fax:787-882-3359
Practice Address - Street 1:CAIMITAL ALTO CARR2KM119.3
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-882-3359
Practice Address - Fax:787-882-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1922288232Medicaid