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General NPI Number Information
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NPI Number | 1134470404
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Entity Type | Organization
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Legal Business Name | JP INTERNAL & CARDIOVASCULAR MEDICINE PSC
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON SUITE 415 TORRE DE AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917-5022
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Country | US
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Telephone | 787-763-9813
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Fax | 787-763-9820
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Provider Business Mailing Address
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Address Line | PO BOX 192382
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City | SAN JUAN
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State | PR
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Zip | 00919-2382
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Country | US
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Telephone | 787-763-9813
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Fax | 787-763-9820
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JOSUE PABON LANDRON
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Credential | MD
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Telephone | 787-763-9813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8158
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License Number State | PR
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