1689213993 NPI number — APS CLINICS OF PUERTO RICO, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689213993 NPI number — APS CLINICS OF PUERTO RICO, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APS CLINICS OF PUERTO RICO, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689213993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 71474
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-8574
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-313-4172
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PLAZA DEL MAR
Provider Second Line Business Practice Location Address:
CARR. 107, KM. 2.3
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-641-0774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2020

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
VP REGULATORY AFFAIRS
Authorized Official Telephone Number:
787-641-0774

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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