Provider Demographics
NPI:1932681798
Name:C MAS CONSTANCY MEDICAL AFFORDABLE SERVICES PSC
Entity Type:Organization
Organization Name:C MAS CONSTANCY MEDICAL AFFORDABLE SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDELMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRILLO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-901-6802
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-0256
Mailing Address - Country:US
Mailing Address - Phone:787-901-6802
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA ROSA 1
Practice Address - Street 2:350 CALLE 1
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-901-6802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care