Healthcare Provider Details

I. General information

NPI: 1487422838
Provider Name (Legal Business Name): JMA ELECTROPHYSIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO STE 200-76
PONCE PR
00716-4717
US

IV. Provider business mailing address

1034 PASEO REAL
PONCE PR
00716-3504
US

V. Phone/Fax

Practice location:
  • Phone: 787-692-3029
  • Fax:
Mailing address:
  • Phone: 939-640-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAVIER EDUARDO MIRABAL ARROYO
Title or Position: PRESIDENT
Credential: MD
Phone: 939-640-3389