Healthcare Provider Details

I. General information

NPI: 1265610919
Provider Name (Legal Business Name): DR JOSE A NASSAR & ASOCIADOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 CALLE FONT MARTELO
HUMACAO PR
00791-3249
US

IV. Provider business mailing address

PO BOX 9132
HUMACAO PR
00792-9132
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-0768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS J NASSAR
Title or Position: SENIOR-PARTNER
Credential: MD
Phone: 787-852-0920