Provider Demographics
NPI:1730515453
Name:DR JOSE M MASSANET CSP
Entity type:Organization
Organization Name:DR JOSE M MASSANET CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASSANET VOLLRATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-740-5151
Mailing Address - Street 1:EDIFICIO MEDIICO HERMANAS DAVILA
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-0001
Mailing Address - Country:US
Mailing Address - Phone:787-740-5351
Mailing Address - Fax:787-740-3001
Practice Address - Street 1:27 CALLE VEREDA
Practice Address - Street 2:URB MONTE VERDE REAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5984
Practice Address - Country:US
Practice Address - Phone:787-740-5351
Practice Address - Fax:787-740-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty