Provider Demographics
NPI:1740437888
Name:ASOCIACION DE MAESTROS DE P R
Entity type:Organization
Organization Name:ASOCIACION DE MAESTROS DE P R
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:787-767-2020
Mailing Address - Street 1:PO BOX 191088
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3490
Mailing Address - Country:US
Mailing Address - Phone:787-763-5560
Mailing Address - Fax:787-767-6600
Practice Address - Street 1:AVE. PONCE DE LEON #452
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-763-5560
Practice Address - Fax:787-766-6700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASOCIACION DE MAESTROS DE P R
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-20
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR138251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0010098Medicare UPIN