MEDICARE: SAN JUAN MEDICAL ASSOC PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1396711198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JUAN MEDICAL ASSOC PSC

Provider Business Mailing Address
First Line	:	RVDO DOMINGO MARRERO NAVARRO STREET
Second Line	:	NUM 4
City	:	SAN JUAN
State	:	PR
Zip	:	00925
Country	:	US
Telephone Number	:	787-766-1081
Fax Number	:	787-282-0869

Provider Business Practice Location Address
First Line	:	RVDO DOMINGO MARRERO NAVARRO STREET
Second Line	:	NUM 4
City	:	SAN JUAN
State	:	PR
Zip	:	00925-0000
Country	:	US
Telephone Number	:	787-766-1081
Fax Number	:	787-282-0869

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. MARIA EUGENIA ZWEIG
Credential	:	MD
Telephone Number	:	787-766-1081

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	02/20/2024

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