Healthcare Provider Details

I. General information

NPI: 1114189594
Provider Name (Legal Business Name): APA HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NO 2 CHARDON AVENUE 2ND FLOOR
HATO REY PR
00918
US

IV. Provider business mailing address

NO 2 CHARDON AVENUE 2ND FLOOR
HATO REY PR
00918
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-0774
  • Fax: 787-641-0777
Mailing address:
  • Phone: 787-641-0774
  • Fax: 787-641-0777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number3906
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number3906
License Number StatePR

VIII. Authorized Official

Name: MS. LESBIA C BETANCOURT
Title or Position: CARE MANAGER SUPERVISOR
Credential: MSW
Phone: 787-641-0774