Healthcare Provider Details

I. General information

NPI: 1073428942
Provider Name (Legal Business Name): JJA HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 JOSE A CEDENO AVENUE NOLLA BUILDING #2
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 1490
ARECIBO PR
00613-1490
US

V. Phone/Fax

Practice location:
  • Phone: 787-544-3108
  • Fax: 787-544-4938
Mailing address:
  • Phone: 787-544-3108
  • Fax: 787-544-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JORGE W MENDEZ
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 787-309-6630