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General NPI Number Information
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NPI Number | 1598385049
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Entity Type | Organization
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Legal Business Name | MEDIEXPRESO LLC
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | VILLA HUCAR C6 CALLE ALMENDRO
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City | SAN JUAN
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State | PR
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Zip | 00920
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Country | US
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Telephone | 787-380-1692
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Fax |
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Provider Business Mailing Address
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Address Line | 1342 AVE ROOSEVELT
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City | SAN JUAN
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-380-1692
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE NEGRON PEREZ
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Credential | MD
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Telephone | 787-548-5380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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