=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518042845
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUAN LUIS SCHAENING M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 03/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1006 CALLE HARVARD, COND. GARDEN CENTER, SUITE C-5 UNIVERSITY GARDENS
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00927-4808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-689-0444
-----------------------------------------------------
Fax | 787-689-1144
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 910 CALLE GEORGETOWN UNIVERSITY GARDENS
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00927-4808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-608-2426
-----------------------------------------------------
Fax | 787-771-4866
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 13057
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------