Healthcare Provider Details

I. General information

NPI: 1609610021
Provider Name (Legal Business Name): MCS ADVANTAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 AVE PONCE DE LEON
SAN JUAN PR
00917-1955
US

IV. Provider business mailing address

PO BOX 191720
SAN JUAN PR
00919-1720
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2500
  • Fax:
Mailing address:
  • Phone: 787-758-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. GILBERTO RAFAEL NEGRON
Title or Position: CORPORATE GOVERNANCE DIRECTOR
Credential:
Phone: 787-758-2500