MEDICARE: MARALANA CSP

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	174400000X	Specialist	9858	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	582987239	OTHER	PR	MAPFRE MEDICARE
8	000041	OTHER	PR	AMERICAN HEALTH MEDICARE
9	200194	OTHER	PR	MEDICARE Y MUCHO MAS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0400850	OTHER	PR	HUMANA INSURANCE
2	582987239	OTHER	CO	CHAMPUS VA
4	3158	OTHER	PR	IMC
5	582987239	OTHER	PR	MEDICAL CARD SYSTEM
6	582987239	OTHER	PR	HUMANA GOLD PLUS
7	PE3364	OTHER	PR	PALIC
10	41675	OTHER	PR	PROSSAM
11	582987239	OTHER	PR	MAPFRE INSURANCE
12	1942	OTHER	PR	PREFERRED MEDICAL CHOICE
13	582987239	OTHER	PR	MCS CLASSICARE
14	82569	OTHER	PR	TRIPLE S
15	582987239	OTHER	WI	TRICARE
16	582987239	OTHER	GA	UNITED HEALTHCARE
17	582987239	OTHER	PR	FIRST PLUS

General Provider Information

NPI Number	:	1497150320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARALANA CSP

Provider Business Mailing Address
First Line	:	PO BOX 7122
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-7122
Country	:	US
Telephone Number	:	787-259-5990
Fax Number	:	787-259-5990

Provider Business Practice Location Address
First Line	:	COLISEO SHOPPING
Second Line	:	2525 AVE EDUARDO RUBERTE SUITE 101
City	:	PONCE
State	:	PR
Zip	:	00728-2813
Country	:	US
Telephone Number	:	787-259-5990
Fax Number	:	787-973-5991

Authorized Official
Title or Position	:	DOCTOR
Name	:	ARMANDO WISCOVITCH
Credential	:	MD
Telephone Number	:	787-259-5990

Provider Enumeration Date	:	11/04/2014
Last Update Date	:	05/04/2026

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Directions to “MARALANA CSP ” Practice Location

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