Provider Demographics
NPI:1932309143
Name:JAA MEDICAL SERVICES CSP
Entity Type:Organization
Organization Name:JAA MEDICAL SERVICES CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ANGLERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-848-7604
Mailing Address - Street 1:REPARTO ANAIDA 4-C20
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2534
Mailing Address - Country:US
Mailing Address - Phone:787-848-7604
Mailing Address - Fax:787-848-7604
Practice Address - Street 1:1243 AVE MUNOZ RIVERA
Practice Address - Street 2:VILLA GRILLASCA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0634
Practice Address - Country:US
Practice Address - Phone:787-848-7604
Practice Address - Fax:787-848-7604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty