Healthcare Provider Details

I. General information

NPI: 1720197338
Provider Name (Legal Business Name): JUAN T TOMASINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLINICA DE LA ESCUELA DE MEDICINA REPARTO METROPOLITANO SHOPPING, AVE. AMERICO MIRANDA
RIO PIEDRAS PR
00921
US

IV. Provider business mailing address

GASTROENTEROLOGIA RCM PO BOX 29134
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-7910
  • Fax: 787-625-1966
Mailing address:
  • Phone: 787-758-2525
  • Fax: 787-758-2583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2766
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: