Provider Demographics
NPI:1316255326
Name:MEDICAL MANAGEMENT & DATA SERVICES, INC.
Entity type:Organization
Organization Name:MEDICAL MANAGEMENT & DATA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMPIERRE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGRAND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-257-0709
Mailing Address - Street 1:P O BOX 3619
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3619
Mailing Address - Country:US
Mailing Address - Phone:787-257-0709
Mailing Address - Fax:787-276-4275
Practice Address - Street 1:ROBERTO CLEMENTE AVE. 66 ST BLOQUE 124 # 8 ALTOS
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-257-0709
Practice Address - Fax:787-276-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR66 072 1132251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage