Provider Demographics
NPI:1427240415
Name:PAR MEDICAL CORPORATION
Entity type:Organization
Organization Name:PAR MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-783-6779
Mailing Address - Street 1:139 CARR 2
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1864
Mailing Address - Country:US
Mailing Address - Phone:787-783-6779
Mailing Address - Fax:
Practice Address - Street 1:139 CARR 2
Practice Address - Street 2:SUITE 3
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1864
Practice Address - Country:US
Practice Address - Phone:787-783-6779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2010-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11522207ZP0102X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0021074OtherMEDICARE PROVIDER NUMBER
PRH70728Medicare PIN