Healthcare Provider Details

I. General information

NPI: 1598773970
Provider Name (Legal Business Name): JORGE A. ALDRICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AVE SAN PATRICIO SUITE 1160
GUAYNABO PR
00968
US

IV. Provider business mailing address

101 SAN PATRICIO AVENUE STE 1160
GUAYNABO PR
00968-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-599-3791
  • Fax:
Mailing address:
  • Phone: 787-599-3791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number13,611
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number13,611
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: