Healthcare Provider Details

I. General information

NPI: 1588509533
Provider Name (Legal Business Name): JHEDERYCK JAVIER FIGUEROA ORTIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO SABANA HOYOS SECTOR RIACHUELO CARR 2 R639 KM 4.5
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 1126
SABANA HOYOS PR
00688
US

V. Phone/Fax

Practice location:
  • Phone: 939-266-3662
  • Fax:
Mailing address:
  • Phone: 939-266-3662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number102299
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: