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General NPI Number Information
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NPI Number | 1932309143
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Entity Type | Organization
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Legal Business Name | JAA MEDICAL SERVICES CSP
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 1243 AVE MUNOZ RIVERA VILLA GRILLASCA
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City | PONCE
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State | PR
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Zip | 00717-0634
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Country | US
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Telephone | 787-848-7604
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Fax | 787-848-7604
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Provider Business Mailing Address
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Address Line | REPARTO ANAIDA 4-C20
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City | PONCE
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State | PR
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Zip | 00716-2534
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Country | US
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Telephone | 787-848-7604
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Fax | 787-848-7604
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE G. ANGLERO
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Credential | MD
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Telephone | 787-848-7604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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