Provider Demographics
NPI:1023229820
Name:ASSMCA
Entity type:Organization
Organization Name:ASSMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENFERMERO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-832-6771
Mailing Address - Street 1:81 CALLE SEVILLA
Mailing Address - Street 2:URB. VISTA ALEGRE
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5909
Mailing Address - Country:US
Mailing Address - Phone:787-882-0208
Mailing Address - Fax:
Practice Address - Street 1:STREET SEVILLA 81URB. VISTA ALEGRE
Practice Address - Street 2:URB. VISTA ALEGRE
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-882-0208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16088261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health