Provider Demographics
NPI:1205619327
Name:APS CLINICS OF PUERTO RICO, INC.
Entity type:Organization
Organization Name:APS CLINICS OF PUERTO RICO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REGULATORY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PESQUERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-641-0774
Mailing Address - Street 1:CAROLINA SHOPPING COURT, ROAD #3, KM. 9.6
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:787-641-0774
Mailing Address - Fax:
Practice Address - Street 1:CAROLINA SHOPPING COURT, ROAD #3, KM. 9.6
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health