Provider Demographics
NPI:1174907760
Name:CCS PSC
Entity type:Organization
Organization Name:CCS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-633-2671
Mailing Address - Street 1:AVE PALMA REAL
Mailing Address - Street 2:MURANO LUXURY 1115
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-7201
Mailing Address - Country:US
Mailing Address - Phone:787-633-2671
Mailing Address - Fax:
Practice Address - Street 1:AVE PALMA REAL
Practice Address - Street 2:MURANO LUXURY 1115
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-7201
Practice Address - Country:US
Practice Address - Phone:787-633-2671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17958207R00000X, 207RC0200X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty