Healthcare Provider Details

I. General information

NPI: 1992727002
Provider Name (Legal Business Name): JORGE ADORNO GIUSTI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SONIA AJ-16 URB VILLA RICA
BAYAMON PR
00959
US

IV. Provider business mailing address

AJ16 CALLE SONIA
BAYAMON PR
00959-4918
US

V. Phone/Fax

Practice location:
  • Phone: 787-785-5487
  • Fax: 787-786-9100
Mailing address:
  • Phone: 787-785-5487
  • Fax: 787-786-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4149
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: