Healthcare Provider Details

I. General information

NPI: 1689277832
Provider Name (Legal Business Name): MA MEDICAL SERVICES PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR #2 KM 55.2 SECTOR PALENQUE
BARCELONETA PR
00617-0001
US

IV. Provider business mailing address

URB. MONSERRATE G2 GOLONDRINA 504
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-567-0581
  • Fax:
Mailing address:
  • Phone: 787-923-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOSE A. MARTINEZ PAGAN
Title or Position: PRESIDENT
Credential: MD
Phone: 787-923-3305