MEDICARE: SAN JORGE ASSOCIATES

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1790793552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JORGE ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 361738
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-1738
Country	:	US
Telephone Number	:	787-728-6902
Fax Number	:	787-728-6902

Provider Business Practice Location Address
First Line	:	258 CALLE SAN JORGE
Second Line	:	303
City	:	SAN JUAN
State	:	PR
Zip	:	00912-3239
Country	:	US
Telephone Number	:	787-728-6902
Fax Number	:	787-728-6902

Authorized Official
Title or Position	:	ADMINISTRATIVE PATNER
Name	:	CARLOS J ESTRADA
Credential	:	MD
Telephone Number	:	787-728-6902

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/22/2020

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