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General NPI Number Information
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NPI Number | 1861384851
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Entity Type | Organization
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Legal Business Name | DESTINATION ENDOCLINIC JSV LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | URB EL RECREO BLOQUE F4 MULTICLINICASENDOCRINOLOGIA HOSPITAL MENONITA
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City | HUMACAO
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State | PR
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Zip | 00791-3230
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Country | US
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Telephone | 787-662-5255
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Fax |
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Provider Business Mailing Address
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Address Line | RR 2 BOX 6090
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City | TOA ALTA
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State | PR
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Zip | 00953-9689
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Country | US
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Telephone | 787-983-1198
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Fax |
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Authorized Official
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Title or Position | ENDOCRINOLOGIST
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Name | DR. JAMILISSE SEGARRA VILLAFANE
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Credential | MD
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Telephone | 787-983-1198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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