Provider Demographics
NPI:1962182659
Name:CHICO, DAMASO (SRNA)
Entity type:Individual
Prefix:
First Name:DAMASO
Middle Name:
Last Name:CHICO
Suffix:
Gender:M
Credentials:SRNA
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 4050
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4050
Mailing Address - Country:US
Mailing Address - Phone:787-878-5475
Mailing Address - Fax:787-880-5195
Practice Address - Street 1:CARR #2 KM 80.4 BARRIO SAN DANIEL SECTOR LAS CANELAS
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614-4050
Practice Address - Country:US
Practice Address - Phone:787-878-5475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program