MEDICARE: FREDDY MAS VARGAS

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	291U00000X	Clinical Medical Laboratory	878	PR

General Provider Information

NPI Number	:	1992836068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDDY MAS VARGAS

Provider Business Mailing Address
First Line	:	PO BOX 745
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-0745
Country	:	US
Telephone Number	:	787-868-4453
Fax Number	:	787-868-0780

Provider Business Practice Location Address
First Line	:	CARR. 417 KM 3.0 BO. MALPASO
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602
Country	:	US
Telephone Number	:	787-868-4453
Fax Number	:	787-868-0780

Authorized Official
Title or Position	:	MEDICAL TECHNOLOGIST
Name	:	MR. FREDDY MAS
Credential	:	MT
Telephone Number	:	787-868-4453

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	05/27/2026

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