Healthcare Provider Details

I. General information

NPI: 1205912631
Provider Name (Legal Business Name): DR. MARIO PAULINO SERV. MED. PED. Y EMERG.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 CALLE SAN JORGE EDIF. SAN JORGE II SUITE 302B
SAN JUAN PR
00912-3307
US

IV. Provider business mailing address

253 CALLE SAN JORGE EDIF. SAN JORGE II SUITE 302B
SAN JUAN PR
00912-3307
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-1000
  • Fax: 787-764-9221
Mailing address:
  • Phone: 939-640-5245
  • Fax: 787-764-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIO E PAULINO SR.
Title or Position: CEO
Credential: M.D.
Phone: 939-640-5245