Provider Demographics
NPI:1366432676
Name:ADAMES, JASON RICHARD (MPT, ATRIC, CSCS)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:RICHARD
Last Name:ADAMES
Suffix:
Gender:M
Credentials:MPT, ATRIC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-0206
Mailing Address - Country:US
Mailing Address - Phone:787-868-6483
Mailing Address - Fax:787-868-5012
Practice Address - Street 1:CALLE COLON
Practice Address - Street 2:#96
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3166
Practice Address - Country:US
Practice Address - Phone:787-868-6483
Practice Address - Fax:787-868-5012
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50411OtherPMC PROVIDER NUMBER
PR6020079OtherHUMANA PROVIDER #
PR33-0434-5OtherACAA PROVIDER NUMBER
PR223259OtherPREFERED HEALTH PROVIDER#
PR652163OtherBELLA VISTA PROVIDER #
PR33-0434-5OtherACAA PROVIDER NUMBER
PR50411OtherPMC PROVIDER NUMBER