Healthcare Provider Details

I. General information

NPI: 1366161275
Provider Name (Legal Business Name): APS CLINICS OF PUERTO RICO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/24/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. DE HOSTOS, EDIFICIO OFFICE PARK SUITE 406 (4TH FLOOR)
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 71474
SAN JUAN PR
00936-8574
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON MORALES
Title or Position: VP OF REGULATORY AFFAIRS
Credential:
Phone: 787-641-0774