Healthcare Provider Details

I. General information

NPI: 1104797307
Provider Name (Legal Business Name): RJ OBGYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AVE. ALBOLOTE PLAZA REAL SHOPPING CENTER SUITE 307
GUAYNABO PR
00969
US

IV. Provider business mailing address

COND. DORAL PLAZA 1019 AVE LUIS VIGOREAUX 5J
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-923-9775
  • Fax:
Mailing address:
  • Phone: 787-923-9775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TAYMARA REYES JIMENEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-923-8775