MEDICARE: ASSMCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	07-F-1998	PR

General Provider Information

NPI Number	:	1164640421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSMCA

Provider Business Mailing Address
First Line	:	PO BOX 21414
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00928-1414
Country	:	US
Telephone Number	:	787-706-1866
Fax Number	:	787-782-2282

Provider Business Practice Location Address
First Line	:	ASSMCA SAN PATRICIO, EDIF 4
Second Line	:	ANTIGUO HOSPITAL DE VETERANOS AVE. DE DIEGO
City	:	SAN JUAN
State	:	PR
Zip	:	00928-1414
Country	:	US
Telephone Number	:	787-706-1866
Fax Number	:	787-782-2282

Authorized Official
Title or Position	:	DIRECTOR CENTRO
Name	:	ORLANDO TORRES
Credential	:	P.H.D.
Telephone Number	:	787-706-1866

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

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Practice Location Address:

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1548481583 — MRS. NANCY VELAZQUEZ SOCIAL WORKER
Practice Location Address:

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1174734008 — MRS. TANIA GARCIA MTS
Practice Location Address:

HOSPITAL RAMON FERNANDEZ, CENTRO MEDICO
SAN JUAN, PR
00928-1414

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1144418674 — DR. AIDA S CARDONA
Practice Location Address:

ASSMCA AVE. BARBOSA # 414
SAN JUAN, PR
00928-1414

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Practice Fax:

1417119058 — DAMARIS NEGRON MD
Practice Location Address:

EDF ADMINISTRACION , RES LUIS LLORENS TORRES
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1538322961 — GISELA AVILES
Practice Location Address:

AVE BARBOSA , EDIF LINCOLN #414
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00928-1414

Practice Phone: 787-763-7575
Practice Fax:

Directions to “ASSMCA ” Practice Location

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