Healthcare Provider Details
I. General information
NPI: 1629955604
Provider Name (Legal Business Name): MEDFACIAL SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BAYAMON MEDICAL PLAZA 1845 CARR 2 SUITE 105
BAYAMON PR
00959-6006
US
IV. Provider business mailing address
CONDOMINIO PUERTO PASEOS 385 AVENIDA DONA FELISA APT 1101
SAN JUAN PR
00926
US
V. Phone/Fax
- Phone: 787-785-8981
- Fax:
- Phone: 787-785-8981
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YX0905X |
| Taxonomy | Otolaryngology/Facial Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YX0007X |
| Taxonomy | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSE
R
SANCHEZ PEREZ
SR.
Title or Position: DR.
Credential: MD
Phone: 787-785-8981