Provider Demographics
NPI:1740453224
Name:REMAS INDEPENDENT PRACTICE NETWORK
Entity type:Organization
Organization Name:REMAS INDEPENDENT PRACTICE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-267-5830
Mailing Address - Street 1:PO BOX 3060
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-3060
Mailing Address - Country:US
Mailing Address - Phone:787-267-5830
Mailing Address - Fax:787-267-0071
Practice Address - Street 1:65 INFANTERIA
Practice Address - Street 2:TENIENTE ALVARADO A1
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-267-5830
Practice Address - Fax:787-267-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization