Healthcare Provider Details
I. General information
NPI: 1659121960
Provider Name (Legal Business Name): JPM SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
A-20 CII PARKSIDE
GUAYNABO PR
00968
US
IV. Provider business mailing address
A20 CII PARKSIDE 2
GUAYNABO PR
00968
US
V. Phone/Fax
- Phone: 787-201-1444
- Fax:
- Phone: 787-201-1444
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JEAN PAUL
MIRANDA
Title or Position: OWNER
Credential: DMD
Phone: 787-201-1444